Medicare Explained

Medicare Explained

If you are turning 65, then you know being eligible for Medicare is just right around the corner. Medicare is a federal health insurance program that is not only available to individuals turning 65 but also for those younger than 65 with a disability or those who have End-Stage Renal Disease. This health insurance program can be a saving grace for many as it can help save beneficiaries thousands of dollars in medical costs.

Medicare is also divided into several parts, each with their own type of coverage.

Medicare Part A

Medicare Part A is one part of Original Medicare and is considered hospital insurance. Part A provides coverage for inpatient services, like hospital stays and care received from a skilled nursing facility, hospice, or home health care.

Many Medicare beneficiaries do not have to pay the monthly premiums for Part A if they or their spouse paid Medicare taxes while working for at least ten years.

Medicare Part B

Medicare Part B is the second part of Original Medicare and is considered medical insurance. It covers outpatient services, doctor services, preventive services, and durable medical equipment. Unlike Part A, everyone must pay a monthly premium for Part B, which is $148.60 in 2021. However, those with a higher income should expect to pay more. Part B also has a deductible of $203 that must be met before the plan provides coverage.

Medicare Part C

Medicare Part C, also known as Medicare Advantage, must cover all services that Original Medicare covers. Medicare Advantage can also provide additional coverage, such as for prescription drugs, dental, vision, hearing, wellness programs, and more. 

There are many different types of Advantage plans, so it is important to choose the right one. The plans include:

  • HMO (Health Maintenance Organization)
  • PPO (Preferred Provider Organization)
  • MSA (Medicare Medical Savings Account)
  • SNP (Special Needs Plan)
  • PFFS (Private-Fee-For-Service)

Medicare Advantage plans can have premiums as low as $0, but the standard monthly premium for these plans in 2021 is $21.

Medicare Part D

Medicare Part D is Medicare’s prescription drug coverage plan. These plans can be purchased through a Medicare Advantage plan as an added benefit or as a standalone plan with your Original Medicare coverage. 

Part D plans are required to cover at least two drugs from each class, as well as cover a majority, if not all, of the drugs listed in these classes:

  • Anticancer
  • Anticonvulsants
  • Antidepressants
  • Antipsychotics
  • HIV/AIDS drugs
  • Immunosuppressants

The standard premium for Part D in 2021 is $30.50.

Don’t Just Settle For Any Coverage

Medicare Supplements

Medicare Supplements, or Medigap, can help cover the expenses that Medicare Parts A and B (Original Medicare) do not cover. There are a number of different plans you can choose from, with each one providing a different level of coverage. Original Medicare will cover your inpatient and outpatient costs, while Medicare Supplements will cover costs like your deductibles or coinsurance.

The Medicare Supplement plans are labeled as A, B, C, D, F, G, K, L, M, and N, and they each provide a specific percentage of coverage for copayments, deductibles, coinsurance, excess charges, blood transfusions, and foreign travel emergency care.

Turning 65? Find Affordable Health Insurance Today!

Now is the time to make a smooth and easy transition into Medicare with Josh Burns at Capstone Insurance & Financial Group in Flowood, MS. With several options to choose from, it’s easy to get overwhelmed, but Josh is an expert and can help you determine your coverage and budget needs.

Give him a call today at 601-273-3690 to learn more about your options!