Medicare Parts A, B, C, and D are th e four distinct types of coverage available to eligible individuals. Each Medicare part covers different healthcare-related costs. While Medicare Part A and Medicare Part B are administered by the Centers for Medicare and Medicaid Services (CMS), Medicare Part C and Medicare Part D are managed by private insurance companies.
Just keep in mind that Medicare is similar to the health insurance coverage you’ve probably had with an employer or individually. It can cover doctor visits, inpatient and outpatient hospital care, prescription drugs, lab tests, etc., and even dental and vision, if you like. It’s just broken out a little different than you’re used to.Here’s a brief overview of each of the parts of Medicare.
What Is Medicare Part A?
Medicare Part A (also known as hospital insurance) is a basic insurance plan that covers medical services related to inpatient hospitalization and skilled nursing care. It is offered at low or no cost to Americans who are 65-years-old (or are soon turning 65) and have contributed towards Social Security, as well as other qualified individuals.
What Medicare Part A Covers:
- Inpatient care in a hospital
- Skilled nursing facility care
- Inpatient care in a skilled nursing facility
- Hospice care
- Home health care
How much does Medicare Part A cost?
If you or your spouse have worked at least 40 calendar quarters in any job where you paid Social Security taxes, you do not have to pay a premium for Part A.
- Premium: $0 per month
- Deductible: $1,408
The Medicare Part A premium for those who do not qualify for $0 premiums is $458/month.
Enrollment Period for Medicare Part A
You’re eligible to enroll in Medicare Part A during the 7-month period around your 65th birthday—beginning three months before the month of your 65th birthday, your birth month, and up to three months after. This is called your Initial Enrollment Period (IEP).
When you apply for Social Security benefits, you’re automatically enrolled in Medicare Part A.
What is Medicare Part B?
Medicare Part B (also known as medical insurance) is an insurance plan that covers medical services related to outpatient and doctor care. Part B covers medically necessary care and treatment, including:
- Medically necessary services or supplies
- Preventive services
- Clinical research
- Ambulance services
- Durable medical equipment
- Mental health services
- Getting a second opinion before surgery
- Limited outpatient medications
How much does Medicare Part B cost?
- Premium: $144.60 per month
- Deductible: $198
- Coinsurance: 20%
Enrollment Period for Medicare Part B
You’re eligible to enroll in Medicare Part B during the 7-month period around your 65th birthday—beginning three months before the month of your 65th birthday, your birthday month, and up to three months after. This is called your Initial Enrollment Period (IEP). Enrollment in Part B is automatic if you are receiving Social Security or Railroad Retirement Board benefits.
What Is Medicare Part C?
Medicare Part C, also called Medicare Advantage, includes the coverage benefits of Medicare Parts A and B. Medicare Part C plans can also offer prescription drug benefits and other additional coverage (like vision and dental). In total, Medicare Part C can cover things like:
- Medicare Part A (hospital insurance)
- Medicare Part B (medical insurance)
- Medicare Part D (prescription drugs)
- Health and wellness programs
How much does Medicare Part C cost?
- Estimated average premium: $30 per month (in addition to your Part B premium)
- Costs may vary significantly between plans.
Enrollment Period for Medicare Part C
You are eligible to enroll in Medicare Part C during the 7-month period around your 65th birthday—beginning three months before the month of your 65th birthday, including the month of your birthday, and up to three months after the end of your birthday month.
Enrollment is optional and not automatic. You must first have Medicare Parts A and B and then sign up for Medicare Part C with a private insurance company and make payments directly to your insurance provider.
What is Medicare Part D?
Medicare Part D, also known as Prescription Insurance, offers coverage for prescription drugs. The prescriptions covered are dependent upon the plan you select and can be found in your plan’s drug formulary.
How much does Medicare Part D cost?
- Estimated average premium: $33.19 per month
- Deductible: $0-$415
Enrollment Period for Medicare Part D
Like Medicare Part C, you are eligible to enroll in Medicare Part D during the 7-month period around your 65th birthday—beginning three months before the month of your 65th birthday, including the month of your birthday, and up to three months after the end of your birthday month. You must enroll directly through an insurance company.
When Can I Enroll in Medicare Part A, B, C, and D?
Which Part is Right for Me: Medicare Part A, B, C, or D?
Which Medicare part(s) you choose depends on what medical services you want covered. Here’s a quick recap of what’s covered under Parts A, B, C, and D:
|Part A||Part B||Part C|
Inpatient hospital visits
Skilled nursing care
Home health care
Some medical equipment
Prescription Drugs (not all plans)
Vision (not all plans)
Dental (not all plans)
HealthMarkets Can Help You Discover Which Type Is Right For Your Needs
To help you decide how to choose what type of Medicare coverage is right for you, review your needs every year. Ask yourself basic questions such as:
- How much can I afford in out-of-pocket expenses?
- Do I want to keep my current providers?
- What prescriptions do I have?
- Do I need coverage for when I travel?
- Which hospitals or doctors are closest to me?
If you’re looking to learn more about Medicare Parts A, B, C, or D, or Medicare Supplement insurance plans, we can help. Talk to a HealthMarkets licensed insurance agent who can provide personalized assistance over the phone or in person. Or, call us today at (800) 439-6916.
http://www.aarp.org/health/medicare-insurance/info-01-2011/understanding_medicare_the_plans.html | https://www.medicare.gov/pubs/pdf/11219-understanding-medicare-part-c-d.pdf | https://www.medicare.gov/coverage/preventive-screening-services | https://www.medicare.gov/what-medicare-covers/what-part-b-covers | https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b | https://www.medicare.gov/coverage/inpatient-hospital-care | https://www.kff.org/medicare/issue-brief/medicare-part-d-a-first-look-at-prescription-drug-plans-in-2019/ | https://www.medicareinteractive.org/get-answers/medicare-prescription-drug-coverage-part-d/medicare-part-d-costs/phases-of-part-d-coverage