When you first become eligible for Medicare, it can be easy to feel overwhelmed with all of your options. This brief guide should help you to understand the different parts of Medicare, so that you can make the selections that are right for your needs.
Medicare Part A and Part B comprise Original Medicare, and work together to form the base of your healthcare needs, so we’ll start by explaining those.
Assuming you’ve worked and paid taxes into the Medicare system for at least 40 quarters in your life, you can enroll in Medicare Part A at age 65 without owing a premium. This will serve as your hospitalization insurance, and will cover costs related to inpatient care in a hospital or skilled nursing facility (subject to some limits). Part A also covers Hospice care or home health care.
Medicare Part B provides for non-hospitalization healthcare needs, such as
- Doctor visits, tests, and other services to diagnose or treat health conditions
- Preventive services (routine screenings, check-ups, vaccinations, etc)
- Mental health services
- Clinical research
- Ambulance services
- Medical equipment
- Some outpatient prescription drugs (limited)
Medicare Part C Plans – also called Medicare Advantage plans – are private health insurance plans designed to offer coverage that is equivalent to Original Medicare. By contracting with Medicare, private insurance companies offer comprehensive health insurance plans through a variety of formats:
- Health Maintenance Organization (HMO) plans
- Preferred Provider Organization (PPO) plans
- Private Fee-for-Service (PFFS) plans
- Special Needs Plans (SNPs)
- HMO Point of Service Plans (HMOPOS)
- Medicare Medical Savings Account (MMSA)
Many Advantage plans also include Part D, or prescription drug coverage. If you choose Original Medicare instead, you can also enroll in Part D to help manage your medication costs.
Now that you’re familiar with the basics, give us a call if you need help making decisions about your Medicare coverage. We can help you understand the benefits and limits of each type of plan, and select the one that is right for your needs and budget.