Understanding Medicare Part ABD and Beyond

Key Highlights

• Medicare is U.S. health insurance for those 65 and older and some younger individuals with disabilities.
• It comprises Part A (hospital insurance), Part B (medical insurance), and optional Part D (prescription drug coverage).
• Medicare Advantage (Part C) bundles Parts A, B, and often D, offered by private insurers under Medicare's regulations.
• Original Medicare (Parts A and B) allows you to see any Medicare-accepting provider in the United States.
• Medicare Supplement Insurance (Medigap) helps cover out-of-pocket costs associated with Original Medicare.

Introduction

Medicare is a health insurance program run by the federal government. It helps many Americans who are 65 years or older. It also covers some people under 65 with certain disabilities. To make the most of your health care benefits, it's important to understand the different parts of Medicare. This blog post will help you learn about the key parts of Medicare, including Parts A and B, along with other options to improve your coverage.

Understanding Medicare's Core Components

Medicare has different parts that focus on special healthcare needs. There are two main options: Original Medicare and Medicare Advantage. Original Medicare is run by the government. Medicare Advantage, on the other hand, comes from private insurance companies approved by Medicare. Let's look at the main differences and what each part includes.

Medicare Open Enrollment: Explore Your Options

Medicare Open Enrollment is your annual opportunity to review and change your Medicare coverage. From October 15th to December 7th, you can:

• Compare options: Explore different Original Medicare Advantage plans and prescription drug plans.
• Make changes: Switch to a new plan that better suits your needs and budget.
• Enroll in coverage: If you're new to Medicare, you can sign up for a plan during this time.

Don't miss out on this chance to ensure you have the right Medicare coverage for the coming year.

Exploring Medicare Part A: Hospital Insurance

Medicare Part A is your hospital insurance. It helps pay for the care you get when you are admitted to a hospital or skilled nursing facility. This includes care for hospital stays that last more than 60 days, and care in a skilled nursing facility after a hospital visit. Part A also covers hospice care for patients who are nearing the end of life. Additionally, it can include some home health care services.

A big plus of Part A is that most people don’t have to pay a monthly premium. This is because they or their spouse paid Medicare taxes while they were working. However, you may have to pay some deductibles and coinsurance costs. These costs will depend on how long and what type of services you get.

Deciphering Medicare Part B: Medical Insurance

Medicare Part B is about medical insurance. It covers many outpatient services and medical supplies. This includes visits to the doctor, preventive services like screenings and vaccinations, and medical equipment such as wheelchairs and walkers. It also includes mental health services. Part B covers some outpatient prescription drugs too, especially those given in a doctor's office.

Unlike Part A, Part B requires a monthly premium that may change depending on your income. Usually, there is an annual deductible and coinsurance for Part B services. The costs you pay out of your pocket will depend on the healthcare services you use throughout the year.

Beyond Basic Coverage: Additional Medicare Options

Parts A and B are the base of Medicare. You can also choose more options to fit your specific needs. These options are Medicare Part C, which is called Medicare Advantage, and Part D, which offers prescription drug coverage. Let's take a closer look at these extra choices.

Medicare Part C: An Overview of Medicare Advantage Plans

Medicare Advantage Plans, also called Part C, give you a different way to get your Medicare benefits. These plans are offered by private insurance companies that work with Medicare. They must cover everything that Original Medicare (Parts A and B) covers. Many Medicare Advantage Plans also include prescription drug coverage (Part D) and may offer extra benefits like dental, vision, and hearing care.

Medicare Advantage Plans can offer more coverage and possibly lower costs for you. However, there are some things to consider. You might have to use certain doctors and hospitals that are in the plan’s network. You may also need to get referrals if you want to see specialists.

The Role of Medicare Part D: Prescription Drug Coverage

Medicare Part D is specifically designed to help cover the costs of prescription drugs. This coverage is not included in Original Medicare and must be purchased separately through private insurance companies offering Medicare-approved plans.

Each plan typically has a formulary and a list of covered drugs, and you may pay different costs depending on the drug's tier within the formulary.

IS THERE A SHARING OPTION FOR ADULTS 65 AND OVER?

Impact Health Sharing offers Individuals 65 and older with Medicare Parts A and B our Impact for Seniors Program. And, with Impact, you will find many of the same things you expect from healthcare insurance and so much more! Impact Seniors enrolled in Medicare Part D have the additional opportunity to engage in our prescription-sharing program, saving money with peace of mind.