The ABCs of Medicare
Medicare is a fundamental part of healthcare for Americans aged 65 and older, as well as for younger individuals with certain disabilities or conditions. However, navigating the various parts of Medicare can be confusing. This guide breaks down Medicare Parts A, B, C, and D, explaining what each part covers and how they work together to provide comprehensive healthcare coverage.
Medicare Part A: Hospital Insurance
Medicare Part A is often referred to as hospital insurance. It covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes while working.
Coverage Includes:
Inpatient care in hospitals
Skilled nursing facility care
Hospice care
Some home health care
Medicare Part B: Medical Insurance
Medicare Part B is medical insurance that covers outpatient care, doctor's services, preventive services, and medical supplies. Part B helps pay for services that Part A doesn't cover, like some doctor's services while you're a hospital inpatient. There is a monthly premium for Part B, which depends on your income.
Coverage Includes:
Services from doctors and other health care providers
Outpatient care
Home health care
Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)
Many preventive services (like screenings, vaccines, and wellness exams)
Medicare Part C: Medicare Advantage
Medicare Part C, also known as Medicare Advantage, is an alternative to Original Medicare (Parts A and B) offered by private insurance companies approved by Medicare. These plans often include Part D and additional benefits not covered under Original Medicare, such as dental, hearing, and vision care.
Coverage Includes:
All benefits and services covered under Part A and Part B
Usually includes Medicare prescription drug coverage (Part D)
May include extra benefits and services, like dental, vision, and hearing
Medicare Part D: Prescription Drug Coverage
Medicare Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare.
Coverage Includes:
Outpatient prescription drugs
Vaccines, biologicals, and some medical supplies not covered by Part B
How They Work Together
Original Medicare includes Part A and Part B. You can add Part D to get prescription drug coverage and a Medicare Supplement Insurance (Medigap) policy to cover gaps in Parts A and B.
Medicare Advantage (Part C) plans combine Part A (hospital insurance), Part B (medical insurance), and usually Part D (prescription drug coverage) into one plan. They may offer additional benefits, but you must use the plan's network of providers.
Understanding the different parts of Medicare is the first step in making informed decisions about your healthcare coverage. Whether you choose Original Medicare with or without additional coverage or decide on a Medicare Advantage plan, knowing what each part offers helps you tailor your healthcare to your needs. Always consider your healthcare priorities, such as the doctors you want to see, your prescription medications, and your budget, to choose the best plan for you.
Turning to Nexus Insurance Advisors for Your Medicare Needs
Navigating Medicare can be overwhelming, but you don't have to do it alone. We're here to help you find the perfect plan for your needs. Give us a call at 856-334-0131 or visit our Contact Us page – let’s make sure you're covered with the best options available!
