Learn More about the parts of Medicare!

The A, B, C, & D of Medicare

Breaking down the basics.

Whether your 65th birthday is on the horizon or decades away, understanding the different parts of Medicare is critical. This government-sponsored program may play a role in your future health care decisions.

Part A of Medicare

Part A: There are two components. In general, Part A covers inpatient hospital care, skilled nursing facility costs, hospice, lab tests, surgery, and some home health care services. One thing to keep in mind is that, while very few beneficiaries may pay Part A premiums out of pocket, annually adjusted standard deductibles still apply.

When it comes to Skilled Nursing Care. Part A will only cover a maximum of 100 days. Medicare requires certain conditions to be met before being admitted to a Skilled Nursing facility.

Under the current Part A Skilled Nursing rules:

  • Days 1-20 would be a $0.00 copay
  • Days 21-100 would be $185.50 daily coinsurance

Knowing the limitations of Part A, some people look for other choices when it comes to managing extended care cost. Such as Long Term Care Insurance.

Part B of Medicare

Part B covers items such as:

  • Physicians’ fees
  • Outpatient Hospital care
  • Certain Home Health Services
  • Durable Medical Equipment
  • And other offerings not covered by Part A.

However, Part B does come with some costs. These cost are adjusted annually. In 2022, the standard monthly premium is $170.10 and the annual deductible is $233.00. The premiums can vary based on the recipients income level.

Part C

Medicare Advantage Plans, (sometimes called Medicare Part C) is as an all-in-one alternative to Original Medicare. The federal government approves these plans sold through private companies. Although, these plans come with standardized minimum coverage, the amount of additional protection offered can differ drastically from one person to the next. This is due to unique provider networks, premiums, copays, coinsurance, and out-of-pocket spending limits. In other words, comparing prices and services offered from different vendors may be the best way to find a Medicare Advantage plan that works for you.

Part D

Part D covers prescriptions drugs. While Medicare Advantage plans often offer prescription drug coverage. Insurers also sell federally standardized Medicare Part D plans as a standalone product to those with Medicare Part A and/or Part B. Every Part D plan has its own list (i.e. “formulary”) of covered medications.

Whether you are new or have been on Medicare for awhile, it is important to know the different parts of Medicare. Understanding the different parts can help when speaking with your healthcare providers and pharmacist.

If you would like to discuss your options please schedule a call on my calendar.

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