What Does Medicare Cover?

Medicare Part A

Medicare Part A covers hospital-related services. It is known as “hospital insurance.” It covers the care you receive as an inpatient in a hospital or a skilled nursing facility as long as it is not long-term or custodial care. It also covers your stay in a hospice facility and may cover some of your home health care.

In order to take advantage of your Medicare Part A coverage, you will need to pay a deductible. This year, the Medicare deductible is $1,556. You will also be charged a coinsurance amount, which is your portion of the bill. The first two months that you are in the hospital, Medicare Part A will fully cover your expenses, but on the 61st day, you will begin to pay $389 each day until the 90th day. You will also have an additional amount to pay if your stay in the hospital lasts longer.

If you or your spouse paid taxes for Medicare for at least 10 years, you will not be charged monthly premiums for Medicare Part A. The payroll taxes that you paid while you were working included Medicare taxes. To be certain, you can consult your Social Security statement to find out if you qualify to have Medicare Part A without paying a premium. This information will be on the Social Security website. If you discover that you do not qualify for Medicare Part A without having to pay a premium, you may still be entitled to it. Unfortunately, your monthly premium may be very high. This year, Medicare recipients are paying premiums as high as $499.

Medicare Part B

Medicare Part B is known as your “medical insurance.” It covers visits to your physician’s office, medical supplies and medically necessary services. It also covers preventive services, mental health services, durable medical equipment and some prescription drugs.

You must pay a premium for Medicare Part B, and this year, it begins at $171.10. A single individual earning an adjusted gross income over $91,000 and a married couple with an AGI of more than $182,000 will be asked to pay the highest premiums. This year, the deductible for Part B is $233. Then, you will be charged 20% of the amount that is approved by Medicare for supplies and services.

Medicare Part B may charge you a penalty if you fail to sign up at the age of 65. The penalty will be 10% of the standard premium for each year that you neglected to sign up for Medicare Part B, and you will be required to pay it for the rest of your life.

Medicare Part C

Medicare Part C is also known as “Medicare Advantage,” but it is a plan that you purchase from a private insurance company. It provides you with the Medicare Part A and Part B benefits you are entitled to along with Medicare Part D. If you purchase a Medicare Advantage plan, you will still need to pay your Medicare Part B premium. This will be in addition to the premium you will need to pay your insurance company for your Medicare Advantage coverage, but most Medicare Advantage plans do not charge a premium.

The “advantage” that you have with a Medicare Advantage plan is that you will receive extra benefits, including dental, hearing and vision coverage. There is also an annual limit on the amount you would be required to pay. This year, the limit is $7,550.

You will be able to choose an HMO or a PPO for your Medicare Part C plan. These require you to remain within your network, obtain authorization for procedures and get referrals to visit specialists. You must also pay copayments and coinsurance for the majority of your services.

Medicare Part D

Medicare Part D is your prescription drug plan. These plans cover brand name and generic drugs, and you must purchase them from a private insurance company. The average premium for Medicare Part D plans is $33 this year. If you are making a particularly high salary, you may be required to pay a higher premium.

You must also sign up for Medicare Part D when you first become eligible, or you may have to pay a penalty. This penalty is equal to 1% of $33.37 multiplied by the number of months that you failed to have prescription drug coverage for 63 days.

What Is Medicare Supplemental Insurance?

Medicare Supplemental Insurance is an insurance plan that you can purchase from a private insurance company that helps you pay the 20% of the costs that Medicare requires you to pay. It is also known as “Medigap.” Depending on the plan that you choose, it could cover the costs that you are charged outside of the United States, coinsurance and deductibles. These plans will not be able to cover private nursing care, hearing aids, vision, dental, prescription drugs or long-term care.

In most states, you have the option of choosing between 10 different Medigap plans. If you are going to purchase a Medicare Advantage plan, you will not be able to purchase a Medigap plan.

How Do You Enroll in Medicare?

You will be automatically enrolled in Medicare when you turn 65 if you are currently receiving Medicare benefits. You will receive Medicare Part A and Medicare Part B. In order to receive Medicare Part D, you will need to enroll on your own.

You will sign up for Medicare through the Social Security website if you are not currently receiving Social Security benefits. You must do this within the enrollment period that begins three months before the month that you turn 65 and ends three months after the month that you turn 65. Signing up during this time will ensure that you don’t have to pay any penalties, and you will not have to wait a long time for your insurance to start.

Now that the time to sign up for Medicare has come, you wouldn’t want to let this moment pass you by. Sign up as soon as possible so that you aren’t penalized.