Do you need help understanding the different parts of Medicare?
Understanding the different parts of Medicare can be confusing. There are four parts of Medicare:
Part A
Part B
Part C
Part D
This post will provide a brief explanation of all of these parts so that it will be more understandable.
The first part of Medicare is called Hospital. Part A of Medicare covers you if you are admitted to a hospital, but can also be some other type of similar facility, such as skilled nursing care, a rehab center or Hospice care.
Part A of Medicare is free for most people. Part A of Medicare begins when you turn 65.
Part B of Medicare is called Medical. Part B of Medicare is any medical care that you need that is not covered under part A. So, if it’s not an overnight stay at a hospital or some other facility then it’s going to be covered under Part B.
So things like going to see your doctor. Maybe after you go to your doctor there might be some follow-up services or treatment like going to the lab to get blood work. Maybe some type of x-rays or testing or some type of physical therapy.
Part B would also help pay for medical care if you need the services of an ambulance or hospital emergency room or if you go to the hospital and have a Surgery in their outpatient clinic and come home that same day. All of these things are covered under part B of Medicare.
Part B of Medicare is not free. You do have to pay a monthly premium for Part B of Medicare. Most individuals start Part B of Medicare at age 65. Some individuals, if they’re still working at age 65 and have their primary health insurance at work, might delay and get Part B of Medicare once they stop working.
Part C of Medicare is Medicare Advantage. A Medicare advantage plan in most cases will be either a HMO or a PPO, or a private fee-for-service plan. These are network plan.
A brief description of a Medicare Advantage plan is that basically the way it works is an insurance company has a contract with the government. The government will pay the insurance company a certain amount of money each year to provide medical care to the insured.
Then the insurance company will enter into contracts with different medical providers in the area with primary doctors, specialists and hospitals that agree to provide medical care to the insured.
The policyholder will then also have a contract with the insurance company whereby they first agree to only go to doctors in the network and also agree to pay either a flat fee which is a co-payment for services received or possibly pay a percentage of the healthcare services that are being received
Generally speaking, a Medicare advantage plan can be very good if you live in an area where there are some really good networks and if your health is really good. So, Part C is Medicare Advantage.
Last is Part D. Part D is prescription coverage. If you have a Medicare advantage plan, most of these plans include some type of prescription coverage.
However, if you do not have a Medicare advantage plan, you most likely will want to get an individual stand alone Part D prescription coverage.
Prescription plans are different in every county, they change every year and which one is the best for you depends specifically on the list of medicines that you need, so you will need to price shop your Part D prescription plan on a regular basis.
The time of year that you’re allowed to price job your Part D prescription plan is in the fall. Its is called the Annual Election Period (AEP). The specific dates for AEP in recent years has been from October 15th to December 7th.
The best way to shop for a Medicare Part D plan is to work with an independent agent.
So, to review:
Part A – Hospital
Part B – Medical
Part C – Medicare Advantage
Part D – Prescription Coverage
I hope this general description of the different part of Medicare have been helpful. If you wish to speak with an independent agent in regards to any of your Medicare health insurance needs, please give us a call at your convenience. Our services are always free to you.
If you have any questions about this subject or would like to speak to us about any of your Medicare needs in regards to Medicare supplement, Medicare Advantage or Part D prescription drug plans, I would certainly be very happy to speak with you.
I am an independent agent specializing in the senior market. I would be very happy to look at your current coverage and compare it to the marketplace to make sure that you are still getting a good value. My services to you will always be FREE.
Billy Williams
800-499-1942
MedicareHealthInsuranceOptions.com
