The A, B, C & D of Medicare
Whether your 65th birthday is on the horizon or decades away, you should understand the parts of Medicare- what they cover and where they come from.
Parts A & B: Originial Medicare. There are two components, Part A is hospital insurance, it provides coverage for inpatient stays at medical facilities. It can also help cover the costs of hospice care, home health care, and limited nursing home care. 1,2
Seniors are frequently warned that Medicare will only pay for a maximum of 100 days of nursing home (skilled nursing) care, Part A is the part that does so. Under current rules, you pay $0 for days 1-20 of skilled nursing facility (SNF) care under Part A. During days 21-100, a $170.50 daily coinsurance payment may be required of you. ²
Part B is medical insurance and can help pick up some of the tab for physical therapy, physician services, expenses for durable medical equipment (hospital beds, wheelchairs), and other medical services, such as lab tests and a variety of health screenings.¹
Part B isn’t free. You pay a monthly premium to get it and a yearly deductible. The premiums vary according to the Medicare recipient’s income level. The standard monthly prermium amount is $135.50 this year. The current annual deductible for 2019, is $185. ³
Part C: Medicare Advantage plans. Private insurance companies offer these Medicare- approved plans. To be eligible for Part C coverage, you must have Medicare Parts A & B and you must continue to pay your Part B premiums and any possible Part C premium. Not all Part C plans are alike. Provider networks, premiums, copays, coinsurance and out of pocket spending limits can vary widely, so shopping around is wise. During Medicare’s Annual Enrollment Period, October 15- December 7, Medicare eligible individuals can choose to switch plans or return to Original Medicare.4,5
Part D: Prescription Drug plans. While Part C plans commonly offer prescription drug coverage, insurers also sell Part D plans as a standalone product to those with Original Medicare. As per Medigap and Part C coverage, you need to keep paying Part B premiums in addition to premiums for the drug plan to keep Part D Prescription coverage in force. 7
Every Part D plan has a formulary, a list of medications covered under the plan. Most Part D plans rank approved drugs into tiers by cost. Medicare.gov makes it easy to find a Part D plan for you.
Liza Harris may be reached at 770-941-6154 or liza@harrisadvisorsgroup.com.
Liza Harris
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Citations.
1 – mymedicarematters.org/coverage/parts-a-b/whats-covered/ [1/29/19]
2 – medicare.gov/coverage/skilled-nursing-facility-snf-care [1/29/19]
3 – medicare.gov/your-medicare-costs/part-b-costs [1/29/19]
4 – medicareinteractive.org/get-answers/medicare-basics/medicare-coverage-overview/original-medicare [1/29/19]
5 – medicare.gov/sign-up-change-plans/joining-a-health-or-drug-plan [1/29/19]
6 – medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap [1/29/19]
7 – ehealthinsurance.com/medicare/part-d-all/medicare-part-d-prescription-drug-coverage-costs [1/29/19]
8 – https://www.medicare.gov/drug-coverage-part-d/what-drug-plans-cover [1/29/19]678
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