Medicare Basics
The A, B, C’s (and D’s) of Medicare
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© Silver Health Advisors – All Rights Reserved
© Silver Health Advisors – all rights reserved
THE ABC & D’s of Medicare
Let’s review what each piece of your medicare coverage does.
Medicare Part A covers
Hospital and skilled nursing facility stays, hospice care at a facility or at home, and home health care.
Some examples of when you would use Medicare Part A:
You would use Medicare Part A if you have rehab from surgery, if you have medical conditions that require regular at-home nurse care, such as a wound that is healing or, to provide comfort care at the end of life in the form of hospice care.
Medicare Part A is provided by the Federal Government.
There is a deductible – which is the amount you are responsible for paying before the Medicare coverage starts to cover your costs.
There are co-pays for services rendered.
Most people do NOT pay an annual premium for Medicare Part A.
Part B
Medicare Part B covers
Outpatient care such, doctor services, physical and occupational therapy, behavioral health services, preventive care.
Some examples of when you would use Medicare Part B
Your Medicare Part B insurance pays for visits to the doctor to deal with early flu symptoms, when you see a psychiatrist because of signs of depression, when you need a wheelchair after surgery, the caregivers who do physical therapy to regain strength are covered by Medicare Part B as well as medications you may need following a surgery but not ongoing.
Medicare Part B is provided by the Federal Government.
There is a deductible – which is the amount you are responsible for paying before the Medicare coverage starts to cover your costs – but not for preventative services like seeing the doctor when you feel sick.
There are co-pays for services rendered that are often 20% or more of the cost of the services you receive.
The annual premiums for Medicare Part B are adjusted based on your annual gross income.
Part C
Medicare Advantage
Medicare Part C is also called Medicare Advantage
Medicare Part C, Medicare Advantage covers everything Parts A & B cover but it is provided by private insurance. You get all the elements that Medicare Parts A & B cover plus coverage for Vision, Dental, and even fitness!
Medicare Advantage also covers Part D: Your Rx drug insurance.
Some examples of when you would use Medicare Part C, Medicare Advantage
Your Medicare Advantage insurance will cover trips to the doctor, the dentist, seeing a specialist, and getting your Rx drugs at a reasonable price. Medicare Advantage works a lot like the insurance you may have had from your job. You have an annual premium, you pay a co-pay, you see the doctor and get what you need, it’s just a lot more affordable than buying private insurance in the marketplace.
Medicare Part C is provided by private insurance but the carriers pay the broker fees, so using a broker to select the best plan does not cost you anything.
There are plans with $0 deductibles.
Co-pays and annual premiums vary by plan and also can be $0.
Part D
Medicare Part D covers
Your prescription drugs.
Medicare Part D is provided by private insurance plans that are approved by Medicare.
There is a deductible – which is the amount you are responsible for paying before the Medicare coverage starts to cover your costs.
There are co-pays and some plans have a $0 co-pay. Part D is most often provided with Medicare Advantage (Plan C).
Medigap
Medigap is also known as Medicare supplemental insurance.
The purpose of Medigap is to fill the gaps left by Medicare Plan A & B leave. Unlike Medicare Part A and B, Medigap is private insurance that works with your Medicare coverage.
There are 10 Medicare supplement insurance plans, labeled “A” through “N.” not to be confused with the Medicare Part A, B, C, and D plans. Each of the Medigap plans and what they cover are regulated by the federal government.
Each Medigap A – N plan provides the same benefits, no matter which insurance company sells it, the difference in the cost is based on the carrier who provides the coverage. Your costs are not higher by using a broker, your costs are determined by the insurance carrier providing the policy.
