Medicare Basics
Medicare is made up of four parts that each cover difference services: Part A, Part B, Part C, and Part D. Parts A & B are administered by the government, while Parts C & D are administered by private insurance companies.
There are several factors to consider when making health insurance choices. Having even a basic knowledge of Medicare and how it functions will enable you to choose a plan that is a good fit for you.
Medicare Part A
Part A is one part of original Medicare and covers inpatient hospital and skilled nursing care, hospice care, and home health care.
Most Part A members do not pay a premium for Part A if they or their spouse have paid Medicare taxes while working for at least 40 quarters (10 years).
Medicare Part B
Part B is the other part of original Medicare and covers medical services such as doctor visits and services that are needed to diagnose or treat medical conditions. Part B also covers preventive services as well as things like clinical research, ambulance services, durable medical equipment and limited outpatient prescription drugs.
Medicare Part C
Medicare Part C is also referred to as Medicare Advantage Plans. By law, a Medicare Advantage Plan must provide all the benefits of original Medicare but may include additional benefits not covered by Medicare, such as prescription drug coverage, hearing aids, vision, and dental. Medicare Advantage plans take the place of original Medicare and are administered by private insurance companies. You must be enrolled in Medicare Part A and B in order to enroll in this type of plan.
Medicare Part D
Medicare Part D is prescription drug coverage insurance. Prescription drug plans function similarly to employer or group coverage with the exception of the coverage gap or “donut hole,” which is part of every Medicare Prescription Drug Plan. The coverage gap is a change in the plan’s coverage once specific costs have been reached by the beneficiary and the insurance company. Generally, more expensive name brand medications cause a person to enter the coverage gap.
