Medicare 101

Covers:
– Inpatient hospital stays
– Care in a skilled nursing facility
– Hospice care
– Some home health care

Cost:
– Part A of Medicare usually has no monthly premium if you or your spouse paid Medicare taxes for a total of 40 quarters while working

– Deductibles/copays (varies depending on the service)

Covers things like:
– Doctor visits
– Outpatient care
– Medical supplies
– Preventative services
– Mental Health services
– Ambulance services
– Laboratory tests and X-rays
– Rehabilitation services
– Home Health Care

Costs:
– Monthly Premium
– Annual Deductible
– 80/20 coinsurance of Medicare approved amount

*Example: If the Doctor bill is $100, the beneficiary pays $20 or 20%.

(Also called a Medicare Advantage Plan) 

Covers:
– Part A
– Part B
– Many also cover part D
– Coverage is all under one plan administered by a private insurance company.

Cost:
– Monthly premium varies between private insurance companies
– If it covers part D, there may be a prescription Annual Deductible
– Copays for different services

(Also called Prescription Drug Plan) 

Covers:
– Medications

Cost:
– Varies

*Part D Prescription Drug Plan, although part of the Medicare Program, is not offered directly through CMS – The Center for Medicare and Medicaid Services. If one wishes to enroll in Part D program, it is done through a private insurance company’s approved plan.

Medicare Supplement Insurance Plan(s) will help pay Part A and Part B deductibles, as well as the Part B coinsurance.   The amount the insurance company will pay depends on which plan you purchase.  All Medicare Supplement Insurance Plan(s) are standardized by the federal government and labeled “A” through “N.”  This means the only difference in benefits for a standardized Medicare Supplement Insurance Plan is the premium an insurance company charges. 

Do Medicare Supplements cover prescription drugs?

• Medicare Supplement Insurance Plan(s) do not include a qualifying Part D Prescription Drug Plan.
• Some plans, however, offer prescription discounts.  A separate stand-alone Part D Prescription Drug Plan is often purchased for prescription coverage