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Medicare Explained – There are 4 main Parts to Medicare: Part A, Part B, Part C and Part D. Part A is your hospital insurance. This Part of Medicare is usually free, and it helps to cover things like inpatient hospital care, skilled nursing facility care and some home health care.
Part A does have some out of pocket costs associated with it – for example, in 2018 there is a $1,340 hospital deductible per 60 day benefit period, so it renews every 60 days. And there is also coinsurance associated with extended hospital days, and skilled nursing facility care.
Medicare Part B is your Medical insurance. This helps to cover outpatient services, things like office visits, diagnostic testing, durable medical equipment and even most non self administered medications. Part B isn’t free – most people pay a standard premium of $134/month for Medicare Part B. Part B services are subject to an annual deductible ($183 in 2018) and then, Medicare Part B pays 80% of Part B covered services after the deductible is met – you pay 20%.
Medicare Parts A and B together are called original Medicare.
Medicare Part C is an optional way to receive your Medicare benefits – so it not mandatory, and in fact it is not ‘original medicare’. Medicare Part C is also called Medicare Advantage, and these are managed care plans that cover Part A and B benefits, and usually include prescription drug benefits as well. If you decide to go with a Medicare Advantage Plan, you typically receive services from network providers, and pay out of pocket in the form of co-pays and coinsurance for certain services.
Medicare Part D is your prescription drug coverage. You can get Part D coverage either built into your Part C Medicare Advantage Plan, or if you have original Medicare you can purchase a stand alone Part D plan. Stand alone Part D plans are offered by different insurance companies and the plan that is best for you will be based on the medications you are taking currently.
These are the four parts of Medicare explained in a nutshell!
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