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  1. Jul 7, 2024 · Medicare Part C plans must cover all of the services covered by Medicare Part A and Part B (except for hospice care, which is generally covered under traditional Medicare Part A even if the beneficiary is enrolled in a Part C plan).

  2. Jan 2, 2024 · There are four parts of Medicare: Parts A, B, C and D. Medicare beneficiaries choose between the parts of Medicare to decide how to receive their benefits. Here’s what you need to know...

    • Part A (hospital insurance) Part A helps pay for inpatient care at: Hospitals. Skilled nursing facilities. Hospice. It also covers some outpatient home health care.
    • Part B (medical insurance) Part B helps cover: Services from doctors and other health care providers. Outpatient care. Home health care. Durable medical equipment.
    • Part C (Medicare Advantage) Part C is known as Medicare Advantage. It’s an alternative to Parts A and B that bundles several coverage types, including Parts A, B, and usually D. It may also include
    • Part D (prescription drug coverage) Part D helps cover prescription drug costs. You must sign up for Part A or Part B before enrolling in Part D.
  3. All Medicare Advantage (Part C) plans cover: All Medicare Part A (hospital) benefits (hospice coverage may be provided, but if not, will still be covered by Part A)* All Medicare Part B (medical) benefits. Most Medicare Advantage plans cover: Prescription drugs.

    • Overview
    • What is Medicare?
    • What does each part cover?
    • What doesn’t Medicare cover?
    • What are the costs for each part?
    • Am I eligible for Medicare coverage?
    • How do I choose a plan?
    • How do I enroll?
    • The takeaway

    •Each part of Medicare covers different services at different costs.

    •Medicare parts A and B together are known as original Medicare.

    •Medicare Part C plans cover everything that original Medicare does and often include additional coverage options.

    •Medicare Part D is prescription drug coverage.

    Medicare is a widely used program. In 2018, nearly 60,000 Americans were enrolled in Medicare. This number is projected to continue growing each year.

    Despite its popularity, Medicare can be a source of confusion for many people. Each part of Medicare covers different services and has different costs.

    Medicare is a health insurance program for people ages 65 and older, as well as those with certain health conditions and disabilities.

    Medicare is a federal program that’s funded by taxpayer contributions to the Social Security Administration. You’ll typically pay 1.45 percent of your earnings toward Medicare, and your employer will match this amount.

    Medicare has four parts. Each part covers different healthcare services you might need.

    Currently, the four parts of Medicare are:

    •Medicare Part A. Medicare Part A is hospital insurance. It covers you during short-term inpatient stays in hospitals and for services like hospice. It also provides limited coverage for skilled nursing facility care and certain in-home healthcare services.

    •Medicare Part B. Medicare Part B is medical insurance that covers everyday care needs like doctor’s appointments, urgent care visits, counseling, medical equipment, and preventive care.

    Part A coverage

    Medicare Part A covers the care you receive when you’re admitted to a facility like a hospital or hospice center. Part A will pick up all the costs while you’re there, including costs normally covered by parts B or D. Part A coverage includes: •hospital stays and procedures •hospice care •limited skilled nursing facility stays •limited home healthcare

    Part B coverage

    Medicare Part B covers a range of everyday healthcare services. In general, Part B covers services that are either medically necessary or preventive. Medically necessary services are ordered by your doctor to treat a condition. Preventive services keep you healthy, like annual physicals or flu shots. Part B coverage includes: •doctor’s office visits •health screenings •annual physicals •vaccines •speech, occupational, and physical therapy visits •specialist’s visits •emergency room visits •urgent care services •emergency ambulance transportation •durable (home) medical equipment

    Part C coverage

    Medicare Part C plans, also called Medicare Advantage plans, are required to cover every service that original Medicare does. Many Medicare Advantage plans also cover additional services such as: •routine dental care •routine vision care •hearing exams and hearing aids •gym memberships and other wellness benefits Additionally, Medicare Advantage plans often include prescription drug coverage under Part D. These all-inclusive Medicare Advantage plans allow you to get all your health services covered in a single plan.

    Medicare only covers items and services it considers to be medically necessary. What’s medically necessary for you can depend on your specific health conditions and situation.

    However, there are generally a few things that original Medical never covers, including:

    •cosmetic surgery

    •dentures

    •routine vision care

    •routine foot care

    Part A costs

    You might hear people discuss Part A as “free.” That’s because most people get Part A without paying a deductible. When you need to use your Part A coverage, however, there are some costs involved. Part A costs include: •Premium. Most people don’t pay a Part A premium, but you might need to in some cases. For example, you may buy into Part A if you haven’t earned enough Social Security work credits. •Deductible. You’ll pay $1,484 each benefit period. •Copays and coinsurance. There’s no copayment on days 0 through 60 of any inpatient stay. Starting on day 61, you’ll pay $371 per day. On day 91, you’ll pay $742 each day until you hit your maximum lifetime reserve days. You get up to 60 of these days to use over your lifetime, and coinsurance costs apply.

    Part B costs

    Your costs for Part B include a monthly premium, annual deductible, and coinsurance. You won’t pay anything for preventive care services like screenings and some vaccines, as long as they’re given by Medicare-approved providers. Part B costs include: •Premium. The standard Part B premium is $148.50 per month. You’ll pay an added surcharge if you have a higher income. •Deductible. You’ll pay $203 for the year. •Copays and coinsurance. You can expect to pay 20 percent of the Medicare-approved cost of all covered services.

    Part C costs

    Your costs for Part C will depend on the plan you choose. Part C plans are offered by private companies that set their own costs and prices. There are plans in a variety of price ranges, from $0 premium plans to more expensive plans that cover a wider range of services. The plans available to you will vary based on where you live. Medicare sets an out-of-pocket maximum for all Medicare Advantage plans. An out-of-pocket maximum is the most your plan can ask you to pay for things like copayments, coinsurance, and deductibles in a year. In 2021, the out-of-pocket maximum for plans is $7,550. Note The Part C premium is paid in addition to your Part B premium. So, for example, if you select a Part C plan with a $30 premium, you’d actually pay a total of $178.50 each month in premiums. You can compare costs for plans in your area on the Medicare website.

    There are a few different ways to become eligible for Medicare. You’ll need to be eligible for and enroll in original Medicare before you can sign up for Part C or Part D.

    You can enroll in Medicare when you meet one of these conditions:

    •you’re turning 65 years old

    •you’ve been receiving Social Security Disability Insurance (SSDI) for 24 months at any age

    •you have a diagnosis of end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS) at any age

    If you’re enrolling because you’ve reached your 65th birthday, you’ll have a signup window that runs from 3 months before your birth month to 3 months after it. You can sign up for Part A and Part B at this time.

    The right plan for you will depend on your budget and healthcare needs.

    For example, if you take multiple prescriptions, you might want to purchase a comprehensive Part D plan with a low deductible. If you know you’ll need vision care services, you might want to select a Medicare Advantage plan that offers vision coverage.

    The options available to you will depend on your city, region, or state, but most areas have a variety of plans to choose from at different price points.

    Tips for selecting plans that meet your needs

    •Assess your current and potential healthcare needs. Are there doctors, facilities, or medications that you can’t compromise on for your care? This may impact your policy choice, particularly when deciding between original Medicare and Medicare Advantage.

    •Consider your income. If you have a fixed or limited income, paying monthly premiums may be difficult. However, if you need care that only Medicare Advantage would cover, this might be a good option to save costs in the long run.

    Enrolling in Part C

    There are two ways to sign up for a Medicare Part C plan: •Online. Shop for Part C plans with Medicare’s plan finder tool. •Through an insurance provider. Insurance companies offer Part C plans, and you can enroll directly with them via their website or by phone.

    Enrolling in Part D

    If you want to enroll in a Medicare Part D plan, there are a few different ways to do so: •By phone. You can call 800-633-4227 (or 877-486-2048 for TTY). •Online. Use Medicare’s plan finder tool to compare Part D plans available in your area. •Contact the insurance company. You can also contact private insurers that offer Part D plans, via their website or by phone, and enroll directly with them. When can I apply? If you’re planning to enroll in Medicare, you’ll need to know several enrollment deadlines and dates: •Initial enrollment period. This is a 7-month window around your 65th birthday when you can sign up for Medicare. It begins 3 months before your birth month, includes the month of your birthday, and extends 3 months after your birthday. During this time, you can enroll for all parts of Medicare without a penalty. •General enrollment period (January 1–March 31). You can enroll in Medicare during this time frame if you didn’t enroll during your initial enrollment period. •Medicare Advantage open enrollment (January 1–March 31). During this period, you can switch from one Medicare Advantage plan to another or go back to original Medicare. You can’t enroll in a Medicare Advantage plan if you currently have original Medicare. •Part D enrollment/Medicare add-ons (April 1–June 30). If you don’t have Medicare Part A, but you enrolled in Part B during the general enrollment period, you can sign up for a Part D prescription drug plan. •Open enrollment period (October 15–December 7). During this time, you can switch from original Medicare (parts A and B) to Part C (Medicare Advantage), or from Part C back to original Medicare. You can also switch Part C plans or add, remove, or change a Part D plan. •Special enrollment period. If you delayed Medicare enrollment for an approved reason, you can later enroll during a special enrollment period. You have 8 months from the end of your coverage or the end of your employment to sign up without penalty.

    Each part of Medicare covers different services and has different costs:

    •Part A covers inpatient care.

    •Part B covers outpatient care.

    •Part C covers everything parts A and B do and often includes Part D as well.

    •Part D covers prescription drugs.

    You need to enroll in both parts A and B before you can buy a Part C or Part D plan.

    • Tess Catlett
  4. There are four parts of Medicare: Part A, Part B, Part C, and Part D. Part A provides inpatient /hospital coverage. Part B provides outpatient /medical coverage. Part C offers an alternate way to receive your Medicare benefits (see below for more information). Part D provides prescription drug coverage.

  5. Oct 25, 2024 · Part A covers hospital care, skilled nursing facility care, hospice care, and home health care. Part B covers visits to the doctor, lab tests, medical equipment, screenings, and a host of...

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