If you are nearing eligibility, it may be helpful to have Medicare explained.
Here is what Original Medicare (Parts A and B) is for as well as a few Medicare insurance plans that you may find necessary to add.
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Original Medicare explained
Original Medicare is Part A and Part B.
Part A is Medicare’s inpatient care coverage.
- Care you receive when you’re admitted to the hospital as an inpatient after an official doctor’s order
- Skilled nursing facility care
- Hospice care
- Home health care
Part B is Medicare’s medical insurance. It covers:
- Medically necessary services or supplies needed to diagnose or treat your medical condition
- Health care to prevent illness or detect it at an early stage
Medicare Advantage is an insurance plan that takes over for your Part A and B coverage while providing additional benefits.
Each plan has an out-of-pocket max (something Medicare doesn’t have) and can include:
- Adult day-care services
- Fitness club memberships
- Prescription drug coverage
- Services and supports for those with chronic conditions
- Transportation to doctor visits
What benefits you are offered will depend on where you live.
Medicare Supplements take care of your cost-sharing responsibilities associated with Original Medicare.
If you were to stick with Original Medicare, you are responsible for 20% of lots of services and care.
Also, if you have a lengthy (or repeat) hospital stay you could become responsible for part of and, eventually, all of your inpatient costs.
There are 10 lettered Medicare Supplement plans which each cover a different percentage of:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part B coinsurance or copayment
- Blood (first 3 pints)
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Part A deductible
- Part B deductible*
- Part B excess charge
- Foreign travel exchange (up to plan limits)
*As of January 1, 2020, Medigap plans sold to new Medicare beneficiaries aren’t allowed to cover the Part B deductible. Because of this, Plans C and F are not available to people new to Medicare starting on January 1, 2020.
Medicare Part D
Original Medicare does not offer any assistance in paying for your prescription medications.
That’s where Part D steps in.
You can get Part D as a standalone plan or through a Medicare Advantage plan.