Medicare has four parts; Part A, Part B, Part C, and Part D. Here is a quick breakdown of these parts.
Part A (Hospital Insurance):
Helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.
Part B (Medical Insurance): Helps cover:
- Services from doctors and other health care providers
- Outpatient care
- Home health care
- Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)
- Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)
Part D (Drug coverage): Helps cover the cost of prescription drugs (including many recommended shots or vaccines). You join a Medicare drug plan in addition to Original Medicare, or you get it by joining a Medicare Advantage Plan with drug coverage. Plans that offer Medicare drug coverage are run by private insurance companies that follow rules set by Medicare.
Part C (Medicare Advantage): Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D.
Medicare Supplemental Insurance (Medigap): Extra insurance you can buy from a private company that helps pay your share of costs in Original Medicare. Policies are standardized, and in most states named by letters, like Plan G or Plan K. The benefits in each lettered plan are the same, no matter which insurance company sells it.
Your Medicare options
When you first sign up for Medicare and during certain times of the year, you can choose which way to get your Medicare coverage. There are 3 main ways:
1. Original Medicare + Part D Prescription Drug Plan
- Original Medicare includes Part A and Part B.
- You can join a separate Medicare drug plan to get Medicare drug coverage (Part D).
- You can use any doctor or hospital that takes Medicare, anywhere in the U.S.
- Your out-of-pocket costs in Original Medicare, including deductibles and coinsurance, and there is no maximum out of pocket.
2. Medicare Advantage Plans (Part C)
- Combine Original Medicare Part A and Part B into a single managed plan. These “combined” plans include Part A, Part B, and usually Part D.
- In most cases, you’ll need to use doctors who are in the plan’s network.
- Plans may have lower out-of-pocket costs than Original Medicare and have a maximum-out-of-pocket amount. So you will not spend more than the maximum-out-of pocket each year.
- Plans may offer some extra benefits that Original Medicare doesn’t cover — like vision, hearing, and dental services.
2. Original Medicare + Medigap + Part D Prescription Drug plan
- To help pay your out-of-pocket costs in Original Medicare (like your 20% coinsurance), you can also buy supplemental coverage, like Medicare Supplement Insurance (Medigap). These plans help pay your portion of your original Medicare costs, including deductibles and coinsurance.
- You will need to enrolling a separate Part D prescription drug plan.
What’s the difference between Medicare & Medicaid?
Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that provides health coverage for some people with limited income and resources. Medicaid offers benefits, like nursing home care, personal care services, and assistance paying for Medicare premiums and other costs.