Medicare consists of four parts. When making the right choices for your healthcare, it is helpful to understand each Medicare part and how it works. Each part of Medicare helps cover different healthcare services. Below we review these four Medicare Parts and how each part of Medicare works to provide you with healthcare coverage.
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What are the Four Parts of Medicare?
Medicare is made up of four parts that provide you with healthcare coverage after you turn 65 or while you are receiving Social Security Disability Income. Each part of Medicare plays a pivotal role in your healthcare. These four parts of Medicare are Medicare parts A, B, C, and D.
Medicare Part A and Medicare Part B make up Original Medicare. This covers your inpatient and outpatient health care.
Medicare Part C and Part D are supplemental coverage for Original Medicare.
Part C is also known as Medicare Advantage. Medicare Advantage plans provide the same coverage as Original Medicare plus additional benefits to provide you with well-rounded healthcare coverage. However, Medicare Advantage plans often have strict networks, referrals, and restrictions. So, it is important to be careful when applying for a Medicare Part C plan. Make sure you choose the right plan to fit your needs. If a plan sounds too good to be true, it may be.
Lastly, Medicare Part D is prescription drug coverage. Medicare Part D is often the most personalized to your healthcare needs. There are hundreds of Medicare Part D plans to choose from and you are eligible to review, and change plans each year if necessary.
Listen to this Podcast Episode Now!What is Medicare Part A?
Medicare Part A is part of Original Medicare and covers your inpatient and hospital service costs. Benefits of Medicare Part A include skilled nursing facility care, home health services, and hospice. When you have Medicare Part A, you are responsible for daily copayments depending on how long you have received care. For most who enroll in Medicare Part A, there is a $0 monthly premium. However, you are responsible for the per occurrence Part A deductible.
To be eligible for zero-premium Medicare Part A you must have worked at least 10 years in the United States paying Medicare taxes. This contribution to Medicare covers your Medicare Part A premiums as long as you are enrolled in the federal healthcare program.
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Why Do I Need Medicare Part A?
If you have not needed hospital or inpatient coverage in the past, you might wonder why you need Medicare Part A. Without proper coverage, hospital stays can be costly. The cost of services and amenities quickly adds up without coverage.
Predicting the future is not possible, so knowing when you will need inpatient coverage is not feasible. If you enroll in Medicare Part A coverage and need hospital and inpatient services in the future, Medicare Part A will provide coverage. Under Medicare Part A, your hospital meals, some hospital rooms, lab tests, x-rays, and more are covered. Additionally, because Medicare Part A coverage does not have a premium for most, it only makes sense to enroll. You have paid into the coverage your entire working life, so it is important to utilize benefits once you qualify.
What is Medicare Part B?
Medicare Part B is the portion of Original Medicare that covers outpatient medical care, such as doctors’ office visits. It covers 80% of services after you pay the annual Part B deductible and your monthly Medicare Part B Premium.
Why Do I Need Medicare Part B?
Medicare Part B is crucial for attending to your health needs. The benefits of Medicare Part B include medically necessary and preventive services. As we age, we are at a higher risk of acquiring chronic health conditions, so preventative services help catch illnesses before it is too late.
Medicare Part B covers your annual physical exams, laboratory tests at doctors’ appointments, mental healthcare, and more. Some of the costs you incur at the hospital might also fall under Part B.
If you delay enrollment into Medicare Part B, you may need to pay a monthly late enrollment penalty. This penalty is not based on your actual premium amount but rather, on the standard Medicare Part B premium. It is important not to wait to apply for Medicare Part B because the Part B late enrollment penalty lasts a lifetime.
What is Medicare Part C?
Medicare Part C is more commonly known as Medicare Advantage, which is private health insurance, including everything under Original Medicare. Medicare Advantage plans often come with prescription drug coverage, as well as dental, vision, and hearing benefits. These plans can also offer perks such as gym memberships.
However, Medicare Part C plans can also add additional restrictions that are not common with Original Medicare. Medicare Part C plans can require you to use specific doctors, require referrals, or pay higher out-of-pocket costs for your healthcare services.
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Why Do I Need Medicare Part C?
It is not necessary to enroll in Medicare Part C. Although it is one of the four parts of Medicare, it exists as one of many options for additional coverage. Medicare Part C covers what Medicare Part A and Part B cover, plus additional benefits.
Many beneficiaries find the relatively low premiums and all-inclusive nature of these Medicare Part C plans attractive. After thoroughly researching their options, some beneficiaries may find additional benefits from choosing to go with a Medicare Part C plan. Especially those under 65 who are eligible for Medicare due to a disability.
For some, Medicare Part C is not ideal, however. If you are someone who likes to keep out-of-pocket healthcare costs low, you may consider another route of coverage.
Medicare Supplement plans can be an alternative option for additional coverage. Researching into Medicare Advantage plans vs Medicare Supplement plans will help you decide whether Medicare Part C or Medicare Supplement plan is your best choice.
What is Medicare Part D?
Medicare Part D refers to prescription drug coverage under Medicare. Like Medicare Part C, Part D prescription drug plans are available through private health insurance carriers. Medicare Part D plans are sold to you based on the drugs you are currently taking. This is because each plan has a different premium. So, agents will review your current prescriptions and help you decide which plan covers them at the most affordable rate.
Why Do I Need Medicare Part D?
When you enroll in a Medicare Part D prescription drug plan, you pay a monthly premium. In exchange, your copays for your prescriptions will be lower.
If you have not taken any prescription medications recently, you might be wondering why you would need a prescription drug plan. Remember that it is essential to consider the future when selecting this coverage. If you need to pay for prescription drugs in the future, you will have coverage in place for fewer out-of-pocket costs.
Similar to Medicare Part B, if you are late signing up for Medicare Part D, you can be subject to a Medicare Part D late enrollment penalty. The penalty gets added to your monthly premium.
Even if you do not currently take any medications, you may notice greater savings in the long run by enrolling in a Medicare Part D plan as soon as you are eligible to avoid the Medicare Part D penalty. If you are assessed the late enrollment penalty, you will be required to pay it for life.
What is Medicare Part F and Part G?
The four parts of Medicare we describe above are the only Parts to Medicare. However, you may also be wondering about additional lettered plans, such as Plan F, Plan G, or Plan N. These plans are known as Medicare Supplement Plans, not Medicare Parts.
Medicare Supplement plans (also known as Medigap plans) are identified as Plans, identified as lettered plans, A through N. If you have ever heard of a Part F or Part G, this was a mistaken reference to one of the most popular Medigap plans.
Medicare Supplement plans provide extra coverage to fill in the gaps Original Medicare leaves uncovered. If you plan on traveling in retirement or would rather not worry about the 20% of expenses uncovered by Medicare, a Medicare Supplement plan could be the right choice for you.
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Medicare Supplement Plan F and Plan G are two of the most popular Medicare Supplement plans available to you. When you enroll in Medicare Supplement Plan F, all the costs left over by Original Medicare are completely covered. This means, you pay $0 out-of-pocket for your healthcare services. Similarly, Medicare Supplement Plan G covers all your costs after you meet the Medicare Part B annual deductible. After you meet this deductible, you are covered at 100%.
How Do I Enroll in Each Part of Medicare?
If you plan to enroll in Medicare Part C, also known as a Medicare Advantage Plan, it is best to do so during your Initial Coverage Enrollment Period. You can also enroll during the Annual Enrollment Period or the Medicare Advantage Open Enrollment Period.
Medicare Part D prescription drug enrollment can also be done during your Initial Enrollment Period or the Annual Enrollment Period.
You might also be eligible for a Special Enrollment Period. Several qualifying life events permit you to change your Medicare coverage at a time other than during the standard enrollment periods.
How to Tackle the Different Parts of Medicare
We know understanding the parts of Medicare is not simple. That is why we are here to help educate you as a beneficiary. Selecting the right coverage for Medicare is easier when you have experts on your side.
When you are ready to select the coverage that is right for you, call us at the number above for a free plan comparison and quotes. If you do not wish to call now, complete our online rate form for available plans in your area.
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Sources:
MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.
- Parts of Medicare, Medicare. Accessed May 2022.
https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/parts-of-medicare - What is Medicare, Medicare . Accessed May 2022.
https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare - Basics Medicare Parts B, C, D, NCDOI. Accessed May 2022.
https://www.ncdoi.gov/consumers/medicare-and-seniors-health-insurance-information-program-shiip/basics-medicare-parts-b-c-d
Is there a list of states that do not support the excess charges for services. I’m on original Medicare plan n ,also d and supplement with cigna. Live in Washington state.
Hi Chester! Yes, our FAQ on state rules has a list of states that do not allow excess charges.