A, B, C & D. Sounds pretty basic, doesn’t it? Well, when it comes to Medicare parts A, B, C, & D it’s not always as obvious as you might expect. Each letter covers an entirely different part of your healthcare, so let’s break it down and take a look at what each letter covers, how it affects you, and what you need to know.
Medicare Part A coverage is your hospitalization insurance. Your Part A Medicare will cover inpatient patient care, a skilled nursing facility, hospice care, and home health care. Most hospitals accept Medicare, but it’s always a good idea to ask beforehand.
Most people qualify for Part A at age 65 simply through work credits. Other times, it’s because of a disability. Medicare Part A typically does not cost anything as you’ve paid the premiums through you (or your spouse’s) taxes your whole working life.
Medicare Part B covers doctor visits and items that are preventive in nature, such as flu shots, vaccinations, annual checkups and screenings for common diseases. It covers standard tests and supplies to diagnose or treat a medical condition. Ask your health care provider if they accept Medicare assignment. If so, you may still have some out of pocket exposure – usually 20%. That’s why you may consider a Medicare supplement policy to cover all or some of the 20% not covered by Medicare Part B.
However, if there is any concern about whether Medicare will cover an item you will be asked to sign a waiver stating you will cover the cost if Medicare does not. So again ask if your provider accepts Medicare.
Unlike Part A, Medicare Part B typically has monthly premiums. You can pay these through Social Security deductions, automatic bank draft or by sending in a quarterly check. Part B premiums are not the same for everyone. Those with higher incomes can be charged extra.
Medicare Part C refers to the optional Medicare Advantage Program. Medicare Advantage plans cover everything normal Medicare Parts A & B cover, but through a private insurance company. In this way, they might be considered as a replacement for Original Medicare A & B.
Advantage providers’ offer various rates and coverage, so be diligent before choosing the Advantage Program. Many will cover additional benefits beyond Parts A & B (like prescriptions for instance), but you need to make sure your preferred doctors and hospitals are in network.
These plans typically use HMO’s (Health Maintenance Organizations) & PPO’s (Preferred Providers). If this is something of interest check if your area has a Medicare Part C organization that accepts the Advantage Program.
Regular Medicare Enrollment Period is from October 15-Dec 7. However, the Medicare Advantage Program also has a Disenrollment period January 1-February 14 if you want to return to original Medicare.
Medicare Part D is optional prescription coverage. Just like Part C, Part D policies are sold by private insurance policies rather than provided through the government. Policies will offer various premiums, deductibles, copay and access to medications – so you want to make sure your agent knows all about your prescription needs. If you have daily prescriptions you use, make sure the policy covers your medication at a reasonable price at your preferred pharmacy.
Most policies cover many generics and brand name drugs. All plans must cover at least 2 prescriptions in every therapeutic category. Where these plans usually differ is how much they pay toward expensive brand and non-brand drugs.
You can check your coverage options with Medicare.gov. However, the easiest way to choose a policy is by talking to us. We are very familiar with Part D coverage insurance offerings.
You can deduct Part D premiums from your Social Security check or pay them directly. It’s usually easier to pay directly in case you want to switch plans the next year.
While A, B, C & D sound pretty basic there are a lot of choices to make, and trying to determine what is best may requires some assistance. The easiest way to navigate the process is by calling the Hyers & Associates team. We are familiar with the plans and the companies offering coverage.
We stay up to date on any changes to the programs. Make sure you’ve ‘got your bases covered’ and get the most coverage for your money. Our team can make this a relatively painless process. Don’t hesitate, give us a call and let us help. That’s what we are here for.