Medicare Parts Explained
There are two main parts of Original Medicare; Part A and Part B. Part C Advantage and Part D prescription drug plans are both additional coverage options.
While Medigap isn’t a “Part” of Medicare, there are ten different “Plan” options available. Some people buy Part C, which sometimes includes Part D.
Others, buy Medigap and Part D. Every person has a different budget and healthcare need. The best plan for you could be different than the best plan for your spouse.
In the content below, we’ll discuss all four parts of Medicare. Then, you can decide on the options that work best for your situation.
Overview of the Four Medicare Parts
First, let’s discuss the basics of each part. Then, we can discuss each benefit in further detail.
Part A covers inpatient services and Part B is outpatient benefits. Part D covers prescriptions.
Then, Part C is a combination of Part A, B, and sometimes D. If Part C doesn’t meet your needs, you have the option to choose Medigap instead.
Tip: Medigap can offer more comprehensive coverage than Advantage plans.
What is Medicare Part A
Part A covers more than a hospital visit. For example, if you need hospice care or skilled nursing after a hospital stay, Part A covers 80% after the deductible.
In 2020, the Part A deductible is $1,408. The deductible applies each benefit period; so, you could pay this multiple times in the year.
Most people get Part A premium-free; but, if you didn’t pay enough into Medicare taxes, you might have a premium. The premium is $458 or $252, depending on the length of time you contribute to Medicare taxes.
Tip: You won’t pay the Part A deductible when you have Medigap coverage.
What Does Part B Cover
The Part B deductible is $198 in 2020. The premium for Part B is 144.60 for most, but high-income earners will pay more. Those that delay enrolling in Part B risk paying the penalty.
If you go to a doctor that doesn’t accept Medicare terms, you pay 15% in Part B excess charges.
Tip: Some Medicare Supplements cover Part B excess charges.
Part C Explained
Part C Medicare Advantage plans require you to have BOTH Part A and Part B. Many Advantage plans include Part D and other extra benefits.
These plans can seem like “All-in-one” Medicare plans. But, depending on who you ask, they might say Medicare Advantage plans are bad.
Sure, these plans offer extra benefits like telemedicine, gym memberships, and routine dental coverage. Yet, the endless copayments can feel like you’re being nickel and dimed.
Further, doctor networks and referrals make these plans less desirable. The premium on many Part C plans is only $0, but in some areas, they do require premium payments.
These plans vary by county. Advantage plans most likely won’t cover you when you travel.
Tip: If you plan on traveling in retirement, a Medigap plan will be the most beneficial for you.
Medicare Part D Explanation
It’s a smart decision to enroll in Part D, even if you don’t have a reoccurring prescription. Delaying enrollment in Part D can result in Penalties. You must have either Part A or Part B to enroll.
The premium cost depends on the plan you choose. Those that take a long list of medications need to consider a comprehensive plan. But, if you don’t take any meds, a low premium policy is sufficient.
Most plans include a deductible. If you have expensive Medications, you’ll likely reach the donut hole.
Tip: When it comes to insurance, something is ALWAYS better than nothing.
Medicare Parts FAQ’s
Do I need Medicare Part C?
No, you don’t NEED Part C. Medicare Advantage plans are an optional benefit. These plans are great for people that can’t afford Medigap or don’t qualify.
The Advantage plans can especially benefit those on Medicaid or under 65.
Who is Eligible for Part D?
Anyone with Part A or Part B is eligible for Part D. If you don’t have Medicare, you don’t get the chance to enroll in Part D.
Private insurance companies sell part D.
Do Medicare Advantage Plans Cover the Donut Hole?
The donut hole is part of the structure of Part D. Advantage plans must adhere to the rules of Medicare.
Those with low-income should consider applying for Extra Help. Extra Help can reduce out of pocket spending.
Find the Best Policy for Your Medicare
Our agents know Medicare is as clear as mud. But, our goal is to help clear things up for you. Whether or not you find Medicare confusing, using an agent can save you time and money.
Do you want to call each insurance company individually or call one company for a quote from all the top carriers? If you want a quote from the top carriers in your area, contact us at the number above.
An agent will ask you a few simple questions about your current policy and your insurance needs. Then, they will recommend the best products for your situation.
Once you make your choice, an agent can walk you through the application process over the phone. Don’t navigate Medicare alone; give us a call and get the opinions of an expert.
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