With the Annual Enrollment Period coming upon us quickly, now is as good a time than ever to revisit the basics of Medicare. Whether you are brand new to Medicare this year or you have had it for several years, it’s always a good practice to get a refresher on this information. There are 4 main parts of Medicare and I’ll go over each of them and their impact to you.
Part A – Hospital
Part A is covered if you are ever an inpatient at a hospital. While there is no monthly premium for this coverage if you’ve paid into Medicare while working (at least 40 quarters), there is a $1,364 deductible. Part A also covers skilled nursing (for the first 20 days), Hospice care, and Home Health Care.
Part B – Medical Insurance
Part B will cover your medical insurance. This includes doctor visits, outpatient services, home health services, durable medical equipment, mental health services, and some preventive services. Part B does have a premium that is paid each month. For 2020 that premium is between $144.60 - $491.60 (your premium is determined by your filed taxes from 2 years ago). There are different payment options to pay for this premium, but most do it automatically through their social security checks. Part B also has a $198 annual deductible and you typically pay 20% for Medicare approved services after you’ve met your deductible.
Medicare parts A and B make up what is called “Original Medicare”. In Original Medicare, there are no networks or referrals needed for doctors or specialist. As long as the doctor accepts Medicare, you may choose any doctor in the US.
Part C – Medicare Advantage
This is an alternative to Original Medicare that is organized by private insurance companies. These “all in one” plans combine parts A and B and typically include part D. Plans may have a lower out of pocket expense than Medicare and most plans have a network that you’ll have to find your services within. There are several plans that have a $0 monthly premium; however, the Part B monthly premium is still required to be paid. Other benefits that some Medicare Advantage plans include are: Dental, Vision, Hearing, Silver Sneakers, Transportation, Part B give back, and more.
Part D – Prescription Drugs
Medicare prescription drug coverage is an optional benefit. Medicare drug coverage is offered to everyone with Medicare. Even if you don’t use prescription drugs now, you should consider joining a Medicare drug plan. If you decide not to join a Medicare drug plan when you’re first eligible, and you don’t have other creditable prescription drug coverage or get Extra Help, you’ll likely pay a late enrollment penalty if you join a plan later
These are the basics of Medicare. Like most things, what is true and good for one person, may not be that way for another. I work with my clients to help them find plans suitable for them and their lifestyle and needs. If you have any questions, concerns, or you want to review the plan that you have (high recommended that you review your Medicare plan annually), please contact me at firstname.lastname@example.org.