If you’re about to turn 65, congratulations! You are now eligible to enroll in a Medicare plan. If the task of selecting a plan that covers everything you need feels daunting, you’re not alone. With several coverage options available, it can be hard to know where to start or how to narrow down which plan you should enroll in.
Medicare is divided into four main parts: Part A, Part B, Part C, and Part D. Understanding your coverage options can help clear confusion and enable you to make a confident decision about your healthcare needs.
In this blog, we’re breaking down Medicare Parts A and B to provide an overview of what to expect from these coverage options.
Medicare Part A: Hospital insurance
Medicare Part A is often referred to as hospital insurance because it primarily covers care provided in clinical settings. Part A helps pay for expenses related to hospital stays, skilled nursing facilities (nursing homes), hospice care, and certain types of home health care.
Typically, you are automatically enrolled in Medicare Part A if you are 65 and already receive Social Security benefits or Railroad Retirement benefits. People under the age of 65 and have been on Social Security Disability for the last two years may also be automatically enrolled in Part A and B. However, it’s always best to consult with a Medicare agency like Medicare 411 to learn more about your eligibility and enrollment status.
Medicare Part A is not always free like some people may assume. Those that are eligible for Medicare can receive Part A premium free if they or their spouse has paid Medicare taxes for at least ten years. Otherwise, your plan may come with a premium that varies from person to person, depending on how many quarters you’ve paid Medicare taxes.
You must pay the deductible once per benefit period after being admitted to a hospital or skilled nursing facility. A benefit period ends after 60 consecutive days of not receiving inpatient care in that type of setting. Your deductible resets after that time period.
Understanding how Part A works can help you make more informed decisions about your healthcare as you transition into Medicare.
Medicare Part B: Medical insurance
Medicare Part B is considered medical insurance because it covers most routine services outside the hospital. This part of Medicare provides coverage for the following:
- Preventive care, such as wellness exams, vaccines, and screenings
- Outpatient services like lab tests, X-rays, and emergency room visits
- Doctor visits to see your primary care physician or specialists
- Durable medical equipment, such as wheelchairs, hospital beds, and other doctor-prescribed supplies
- Some home health services, including part-time nursing or therapy care
Medicare Part B has a monthly premium that varies based on income. Similar to Part A, this plan also includes a small annual deductible you must pay before your coverage begins. Once you’ve met your deductible for the year, Medicare covers the majority of your approved medical services.
However, your exact coverage and out-of-pocket costs can vary depending on several factors, like your provider, the services you need, and your specific coverage. It’s always best to review your benefits carefully or speak with a trusted Medicare Translator from Medicare 411 to understand what you’ll be financially responsible for with Medicare Part B.
Original Medicare: Medicare Parts A & B together
Together, Medicare Part A and B make up Original Medicare. Normally, these two parts go hand in hand to help pay for your inpatient and outpatient medical services. It’s important to know that Original Medicare does not cover everything you may need. Services such as dental, vision, hearing aids, and most prescription drug coverage are not included. You may also be responsible for deductibles, coinsurance, and other out-of-pocket costs.
By talking to a trusted Medicare Translator, you can learn more about Medicare Parts A and B to ensure your healthcare coverage fits your needs.
Contact your local Medicare Translators at Medicare 411 to learn more about your coverage options during the Annual Enrollment Period
Our Medicare Translators are here to help you live easy and feel confident in your Medicare coverage. We’ve been serving Northern Illinois and the surrounding area for the past eight years, helping hundreds of people like you.
As a locally owned and operated Medicare insurance agency, we provide local services with a familiar area code. We’re here to answer any questions you may have, guide you through the enrollment process, and be available to support you in making important decisions about your health care coverage.
Contact us today at 815-329-6937 to schedule a free review of your benefits at our Rockford, Illinois office, located at 5192 Harrison, Rockford, IL 61108.
Disclaimer! **We honor the privilege of providing you help with your individual health and Medicare needs. As an independent insurance agency, we are client advocates. We do not offer every plan in your area, currently we represent 12 companies with over 100 plans in the Illinois and Southern Wisconsin market and many more in the over 28 states where we are licensed and certified for Medicare products. For all your plan options, contact Medicare at Medicare.gov or 1-800-Medicare or your State Health Insurance Program for help with your plan choices.
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