Medicare can be a difficult plan to maneuver. Most people who sign up for Medicare are surprised by how many different choices they can make for their desired coverage.
There are four main parts of Medicare and a few bonus parts if you need them. Let’s dig into each one and explain what they mean. Why do you even need to know this?
You have one choice to make when going through Medicare: the original Medicare plan, or Medicare Advantage. At the end of this article, I’ll explain how these four parts play into that decision.
Part A- Hospital Coverage
Part A is included in both Medicare plans. If you have to stay in the hospital for any reason, Part A will cover it.
Part A also covers any hospice care or in-home nursing that you may need due to a serious condition. You are also covered for a stay in a skilled nursing facility after you are transferred from a hospital for wound care of tubal feeding.
This part usually doesn’t have a premium since you pay taxes for this, but it does carry a deductible, so it isn’t free. Any cost above the deductible will be covered by your Medicare plan.
Part B- Outpatient and Doctor Coverage
The second part of Medicare, or Part B, covers bills related to outpatient services or doctor’s visits. It also covers ambulance rides, lab tests, diagnostics and any equipment you need for in-home care.
Unlike Part A, Part B is not covered by your taxes and costs a pretty hefty monthly premium AND you pay 20% of all costs. If you don’t need this part of Medicare, it’s smart to forego signing up for this.
Part C- Medicare Advantage
This is where things get tricky. Part C is like the private insurer’s version of the government’s Medicare, although under contract with the federal government. This often bundles a version of Part A and B but it varies from plan to plan.
These plans often offer more than the original Medicare such as vision and dental and some even offer housekeeping, but you’ll have to check with each provider to see their offerings.
You’ll still be paying a premium and have a deductible. It may be higher than the original, but you might be getting more from it. It’s important that you compare each plan.
Part D- Prescription Drugs
Last but not least, this part of the Medicare plan covers some, but not all, of your prescription drugs. You can expect to pay a flat copay or a percentage of the cost of your prescriptions, and a deductible. If you need really expensive prescription drugs, you could qualify for what the government calls the “doughnut hole” coverage or extra coverage that helps fill the gap.
Now is the time to decide. Will you go for Medicare or Medicare Advantage? With Medicare, you can pick and choose which of parts A, B, and D you need or would benefit from.
Medicare Advantage is a more comprehensive plan that can cover all three. If you are in need of all three, this would be the way to go as they often offer a more competitive rate and some great bonus insurance.
However, if you are still working and have some coverage from your job, you’d be best to stick to only Part A and maybe part D to help with medical costs.