Medicare

Explore Part A, Part B, Part D Prescription Drug Plans, Medicare Advantage Plans, Medicare Supplement Insurance Plans

MEDICARE PART A

Medicare Part A encompasses hospital expenses, such as stays, skilled nursing care, hospice, and home health-care services. Deductibles, coinsurance, and copayments apply. Eligibility for Part A is earned by contributing Medicare taxes over 10 years (or 40 quarters) of work. Without earned eligibility, a premium is required.

MEDICARE PART B

Medicare Part B extends coverage to medical services addressing illnesses and conditions, including doctor’s visits, lab work, x-rays, and outpatient surgeries. It encompasses preventive care such as cancer screenings and flu shots, as well as essential durable medical equipment like wheelchairs and walkers for treating ailments. While Part B premiums are typical, even when enrolled in a Medicare Advantage plan covering Part A and Part B, the Part B premium remains applicable.

MEDICARE PART D

Original Medicare does not provide coverage for prescription drugs. While Medicare Part D is optional, it offers value for medication needs. Failing to enroll in Medicare Part D when initially eligible may result in a late-enrollment penalty. You can obtain Medicare Part D prescription drug coverage either via an independent Prescription Drug Plan (PDP) or through a Medicare Advantage Plan that incorporates prescription drug coverage.

Before picking a plan, grasp the contrasts between Medicare Supplement Insurance Plans and Medicare Advantage Plans.
Many mistakenly enroll in Medicare Advantage Plans, thinking they're Medicare Suplement Insurance Plans — yet they're not.

Medicare Choices

Medicare Supplement Insurance Plans

A Medicare Supplement plan works alongside Original Medicare. Any care provider who accepts Medicare will take out a Supplement, which streamlines billing. Original Medicare covers its share (usually 80% of covered services) and the remaining bill is transferred to the Medicare Supplement Insurance Plans (usually 20%). It is important to note that the Medicare Supplement Insurance plans exclude prescription drug coverage; failure to enroll in a Part D Prescription Drug Plan on time will result in penalties. Medicare Supplements Insurance Plans remain the same each year, although the monthly premium may increase, coverage remains the same.

Medicare Advantage Plans

Medicare Advantage plans are sometimes called “Part C” or “MA plans”. Private companies approved by Medicare offer these comprehensive options. Enrolling in a Medicare Advantage plan ensures your continued Medicare coverage. These comprehensive plans include Medicare Part A (hospital insurance), Medicare Part B (medical insurance), and often prescription drug coverage. Most also offer additional benefits such as vision, dental, hearing aids, and more.

Part D Prescription Drug Plans

Part D Medicare Prescription Drug Plan augments Original Medicare, extending coverage to medications. Often termed “PDPs,” these plans are compatible with Original Medicare, some Medicare Cost Plans, specific Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.

Each Medicare Prescription Drug Plan features an exclusive list of covered drugs, known as a formulary. Within these formularies, various tiers categorize drugs, each with distinct costs. Typically, drugs in lower tiers incur lower expenses than those in higher tiers. In specific instances, if your prescribed drug is categorized in a higher tier, and your healthcare provider deems it necessary over a similar lower-tier alternative, you can request an exception from your plan for reduced copayment.