Medicare 101

Original Medicare Part A is provided by the federal government

Covers:

• Helps pay for hospital stays and inpatient care

• Helps pay for care in a skilled nursing facility

• Hospice care

• Some home health care

Cost:

• Typically no monthly premium

• Deductible during 2024 is $1,632 (which can be up to 5x/year)

• Copays (varies depending on the service)

*Example: If you were hospitalized for a three-day stay you must pay $1,632 for your Part A deductible. 

Original Medicare Part B is also provided by the government

Covers most:

• Doctor visits

• Outpatient care

• Medical supplies

• Preventative services

• Mental Health services

• Helps with ambulance services

• Laboratory tests and X-rays

• Rehabilitation services

• Home Health Care

Costs:

• Monthly Premium for 2024 is typically $174.70

• Annual Deductible for 2024 is $240.00

• 80/20 coinsurance of Medicare approved amount

• No out-of-pocket limits on expenses

*Example: If the doctor bill is $100, the beneficiary pays $20 or 20%.

Advantage Plans

Bundles:

• Part A

• Part B

• Many Advantage Plans include Part D

• Coverage is all under one plan administered by private insurance companies

Cost:

• Monthly premium varies according to the private insurance company selected

• If the plan covers Part D, there may be a prescription annual deductible

• Copays for different services

* You must be enrolled in Part A and Part B to be eligible for a Part C Plan

Also called Prescription Drug Plans

Covers:

• Types of drugs most commonly prescribed according to Federal standards

• Offered by private insurance companies approved by Medicare

Cost:

• Varies

* You must be enrolled in Part A and Part B to be eligible for a Part D Plan

Also called Medigap Plans

Many Medicare Supplement Insurance Plans will help pay the Part A deductible as well as the Part B coinsurance. The amount the insurance company will pay depends on which plan you purchase. All Medicare Supplement Insurance Plans are standardized by the federal government and labeled “A” through “N.”  This means the only difference in benefits for a standardized Medicare Supplement Insurance Plan is the premium an insurance company charges. 

Do Medicare Supplements cover prescription drugs?

• Medicare Supplement Insurance Plan do not include a qualifying Part D Prescription Drug Plan.

• Some plans, however, offer prescription discounts. A separate stand-alone Part D Prescription Drug Plan is often purchased for prescription coverage.