Medicare Part A

 

Part A of Medicare is your hospital insurance. This helps you cover common hospital expenses for things such as the cost of a semi-private room for stays, hospice, home health care and even skilled nursing facility stays. This part of Medicare also covers blood transfusions requiring more than 3 pints of blood.

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Part A is also free for most people as long as they have worked at least 10 years in the U.S. or are married to someone who is at least 62 and has worked those quarters.

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Think of Part A as your room and board in the hospital. This part of Medicare provides you a semi-private room for your hospital stay and with meals and medical services while you are in the hospital.

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Sometimes particularly healthy people wonder if they may need only Part A. Perhaps they don’t use many medical services yet and so they wonder if they can get away with Part A alone.

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However, there are many things that happen in a hospital that fall under another part of Medicare – Part B, so it’s important that you enroll in both A & B unless you have other coverage coordinating with Medicare.

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Medicare Part B

 

Part B of Medicare is for outpatient services that are deemed medically necessary. Medicare Part B includes coverage for services like doctor office visits, lab testing, diagnostic imaging, preventive care, surgeries, ambulance rides, chemotherapy and radiation, and even extensive dialysis care for people with renal failure. Many of these procedures may occur in a hospital. However, they fall under Part B because physicians provide them, so it’s not always easy to determine what is inpatient vs outpatient care.

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Now those two different parts of Medicare – Parts A and B together – make up what we call Original Medicare. They are only two parts that you will sign up for at the Social Security office or Railroad Retirement Board.

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Medicare Part C

 

Part C of Medicare is somewhat confusing. Unlike the other parts of Medicare, which cover specific medical benefits, Medicare Part C is just another name for private Medicare insurance. The Balanced Budget Act of 1997 created Part C, which is now referred to as Medicare Advantage.

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Medicare Advantage plans are private health plans that you can choose instead of Medicare. You would get your Part A, Part B, and sometimes also Part D all from one insurance carrier. Advantage plans usually have a network of providers from whom you will seek your care.

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Part C plans can often have lower premiums than Medigap plans. However, you’ll pay more copays as you go along so they are not necessarily cheaper over the long term.

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Medicare Part D

 

Part D is a federally created program to help you lower the cost of your retail prescription drugs. Unlike Medicare Part A & B, you will not enroll in Part D through the Social Security office. Instead, you will select one of the Part D plans available in your county from private insurance carriers.

By signing up for that plan, you will have enrolled in Part D.

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Medicare drug plans are optional. You’ll have a monthly premium that you will pay to the insurance carrier. In return, they give you significantly lower copays on your medicines than you would pay if you had no Part D insurance.

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