Medicare consists of four parts. When making the right choices for your healthcare, it is helpful to understand each part and how it works.
4 Medicare Parts Explained
Original Medicare consists of Medicare Part A and Part B. Part C and Part D are additional coverage options. We are here to eliminate any confusion about the parts of Medicare and which of your health needs they cover.
Medicare Part A
Part A is part of Original Medicare and covers your inpatient and hospital service costs. Benefits of Part A include skilled nursing facility care, home health services, and hospice. After paying your Part A deductible, it covers 80% of your expenses. Most beneficiaries do not pay a premium for Part A, but you might need to if you do not pay enough into Medicare taxes.
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 Part A. Without proper coverage, hospital stays can be costly. The cost of services and amenities quickly adds up.
Should you need hospital and inpatient services in the future, Part A will provide coverage. Under Part A, your hospital meals, some hospital rooms, lab tests, x-rays, and more are covered, as well as the initial 60 days of your stay. It is important to enroll in both Part A and Part B, as described below.
Medicare Part B
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 deductible and your monthly Part B Premium.
Why Do I Need Medicare Part B?
Part B is crucial for attending to your health needs. The benefits of Part B include specialist services and preventive services. As we age, we are at a higher risk of acquiring chronic health conditions.
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.
What Happens if I Delay Signing Up for Part B?
If you delay enrollment into 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 Part B premium. It is important not to wait to sign up for Part B because the Part B late enrollment penalty lasts a lifetime.
Medicare Part C
Part C is Medicare Advantage, which is private health insurance, including everything under Part A and Part B. 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.
Why Do I Need Medicare Part C?
It is not necessary to enroll in Part C. Although it is one of the four parts of Medicare, it exists as one of many options for additional coverage.
Many beneficiaries find the relatively low premiums and all-inclusive nature of these plans attractive. After thoroughly researching their options, some benefit from choosing to go with a Medicare Advantage plan. Especially those under 65 who are eligible for Medicare due to a disability.
Researching Medicare Supplement plans as an alternative option for additional coverage will help you decide whether Part C or Medigap is your best choice.
Medicare Part D
Part D refers to prescription drug coverage under Medicare. Like Part C, Part D prescription drug plans are available through private health insurance carriers. You only sign up for Part A and Part B through Social Security.
Why Do I Need Medicare Part D?
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 and fewer out-of-pocket costs.
When you enroll in a Part D prescription drug plan, you pay a monthly premium. In exchange, your copays for your prescriptions will be lower.
What Happens if I Delay Signing Up for Part D?
Like with Part B, if you are late signing up for Part D, you can be subject to a late enrollment penalty. The penalty gets added to your monthly premium. Even if you do not currently take any medications, you should not wait to sign up for Part D because the penalty remains for as long as you are on the plan.
Part F and Part G
The four parts of Medicare described above are the only “Parts” to speak of. Medicare Supplement (also known as Medigap) plans are identified as “Plans,” lettered A through N. If you have ever heard of “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 Medicare leaves uncovered. If you plan on traveling in retirement or would rather not worry about the 20% of expenses uncovered by Medicare, a Medigap plan could be the right choice for you.
What Parts of Medicare are Free?
Unless you have not paid enough in Medicare taxes, you will not pay a premium for Part A. If you require help paying for other parts of Medicare due to being on a fixed income, see if you qualify for a Medicare Savings Program or Extra Help.
You can enroll in Part D prescription drug coverage 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.
Do I Need Each Part of Medicare?
Many beneficiaries wonder if they need each part of Medicare. The answer is different for everyone. For the most part, the answer is, yes. If you want inpatient coverage, or coverage for when you end up in the hospital, then you need Part A. If you want outpatient coverage, or coverage for your doctors visits, preventive exams, testing, etc, then you need Part B.
If you can afford the out of pocket expenses in the form of cost-sharing that falls under both Part A and Part B, then you do not need additional supplemental coverage. However, cost-sharing can quickly add up, especially in the case you become sick. In addition, if you become sick, you may be denied any supplemental coverage in the future.
When it comes to supplemental coverage, you have the choice between Medigap and Part C. If you cannot afford the above cost-sharing mentioned, then you need either Medigap or Part C.
When it comes to Part D, if you take any prescription medications, or may in the future, then you need Part D. Otherwise, you will have no coverage for your prescriptions if you only have Part A and Part B.
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 consultation and quotes. We also have an online rate form if you wish to start comparing plans today!
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