Basic Medicare Parts
By Kendra Knouff
eMedicareSupplements Senior Writer
Part A benefits covers:
- Inpatient hospital care (including inpatient rehabilitation facilities and long-term care hospitals)
- Skilled nursing facility care (this does not include custodial or long term care) Hospice care
- Home health care
- Inpatient care in a Religious Nonmedical Health Care Institution
It is important to note that Medicare Part A plans usually have no deductible or monthly premium because these fees are usually paid through taxes during employment. This is known as premium-free Part A.
Part B covers physician and out-patient rehabilitation costs. These include medically-necessary costs, such as those associated with services or supplies rendered to diagnose or treat a medical condition and preventative costs associated with detecting and treating early onset illnesses (such as the flu).
Medicare Part B is offered at a monthly premium and an annual deductible. Once this deductible is met, Medicare will pay 80 percent of medical costs, and the beneficiary is responsible for the remaining 20 percent.
Many seniors opt to enroll in both Medicare parts A and B in order to cover the basic healthcare costs they may face. This is known as Traditional Medicare coverage.
Part C is known as Medicare Advantage. Medicare Advantage covers everything included in parts A and B and also provides emergency room and urgent care coverage. Part C also offers prescription coverage that is not dependent on Medicare Part D enrollment and may include vision, dental, hearing, preventative care, and health and wellness benefits, such as a gym membership. These plans do not offer hospice coverage.
Medicare Part D covers prescription drug coverage for seniors. Part D is offered in one of two ways:
- Medicare Prescription Drug Plans- This option adds drug coverage to Original Medicare, Medicare Medical Savings Account Plans, and certain Medicare Cost and Medicare Private Fee-for-Service Plans.
- Medicare Advantage Plans- These plans offer coverage for Medicare Parts A and B as well as Part D prescription drug coverage.
Part D Coverage may be subject to a deductible; different plans and co-pay levels are also available. This coverage is accepted at pharmacies and through mail order. Part D coverage also covers many generics that fall into the coverage gap.
Additional Coverage Options
Option 1: Medicare Advantage Plans- In addition to the coverage offered through Medicare parts A and B, these plans also offer a variety of extra coverage for seniors. These extra benefits include coverage for vision, dental, hearing, preventative care, health and wellness, and prescription drug coverage. This is all available for a low monthly premium.
Option 2: Medicare Supplemental Plans- Many seniors choose a supplemental plan to fill in the gaps in their Medicare parts A and B coverage. These supplemental plans are known as Medigap plans. They cover parts A and B; however, seniors are responsible for purchasing another plan to cover Part D prescription drug coverage. These supplemental plans are standardized by Medicare and their premiums start at about $110 per month. These plans offer extra coverage and are available through most insurance companies.
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