Medicare is a federal health insurance program primarily for people 65 and older and younger adults with certain disabilities. It consists of four parts:
- Medicare Part A: Hospital Coverage
- Medicare Part B: Medical Coverage
- Medicare Part C: Medicare Advantage
- Medicare Part D: Prescription Drug Coverage
Below is a breakdown of each part and explore potential cost-savings you may consider.
Jump to
Part A | Part B | Part C | Part D
What it covers:
- Hospital inpatient stays
- Home health care
- Behavioral & Mental Health
- Hospice care
- Skilled nursing care
Eligibility:
- Most people, who have worked and paid Medicare taxes for at least 10 years, are eligible for Part A hospital insurance – premium-free. If you or your spouse didn’t work long enough, you may have to pay a monthly premium.
Some cost-considerations:
- Deductible: You’re responsible for a deductible for each benefit period.
- Coinsurance: After a certain number of days or terms (e.g. deductible being met), you may need to share in the cost.
- Skilled nursing facility care: Covers skilled nursing care for a limited time (on a short-term basis) if you meet specific criteria.
- Hospice care: Medicare covers most hospice care costs.
- Home health care: Medicare generally covers short-term home health care if you meet certain conditions.
Learn more about what Part A covers.
What it covers:
- Doctor’s services
- Outpatient care
- Medical supplies
- Preventive services
Eligibility:
- Most people are eligible for Part B, but you’ll pay a monthly premium.
Some Cost-considerations:
- Preventive services: Many preventive services are covered without copays or deductibles.
- Medicare Savings Programs: If you meet certain income and resource limits, you may qualify for the Medicare Savings Program (MSP), which provides extra help paying Medicare premiums, deductibles, and coinsurance.
Learn more about what Part B covers.
What it covers:
- All benefits of Part A and Part B
- Often includes Part D prescription drug coverage
- May offer additional benefits like vision, dental, OTC and fitness programs
Eligibility:
- You must be enrolled in Parts A and B to join a Medicare Advantage plan.
Cost-saving options:
- Lower premiums: Some plans may have lower premiums than Original Medicare.
- Additional benefits: Many plans offer extra benefits not covered by Original Medicare, such as hearing, vision, dental and OTC benefits
- Lower out-of-pocket costs: Some plans have lower deductibles and coinsurance.
What it covers:
- Prescription drugs
Eligibility:
- You can enroll in a Part D plan if you have Original Medicare or a Medicare Advantage plan without drug coverage.
Cost-saving options:
- Medicare Savings Programs: You may get extra help paying for your prescription drugs if you qualify for the Medicare Savings Program (MSP)
- Low-income subsidy: You may be eligible for Extra Help, also known as a low-income subsidy, to help with costs.
- Generic drugs: Using generic drugs can often save you money.
- Mail-order pharmacies: Some plans offer lower prices for mail-order prescriptions.
Important Note:
- Costs and coverage can vary depending on the specific plan you choose.
- It’s essential to review your Summary of Benefits (SOBs) annually to understand your benefits and potential cost-saving options.
Remember: This information is a general overview. For specific details about your coverage and costs, contact your Medicare or Medicare Advantage plan or visit Medicare.gov.
Disclaimer: This information above is intended for informational purposes only and does not constitute financial or legal advice.
Source:Medicare.gov
