What are the Different Types of Medicare?

The Four Parts of Medicare

Medicare Comes in Four Parts - each providing different types of coverage.

◾Part A - Hospital
       insurance 
◾Part B - Physicians, durable
       medical equipment, lab
       fees etc.
◾Part C - Medicare
      Advantage - a government-
      sanctioned private health
      insurance plan that
      replaces Medicare Parts A
      and B for those who want to
      access their Medicare
      benefits via managed care
      organizations
◾Part D - Prescription Drugs

FAQS ABOUT MEDICARE

What is Original Medicare

Parts A and B are sometimes referred together as "Original Medicare"

That's because Medicare Parts A and B were the first two parts of Medicare authorized by Congress when Medicare was first passed in 1965.

Read our newly updated 2023 Medicare Playbook

Medicare Part A - Hospital Insurance

Medicare Part A is available to eligible individuals who are 65 or older, have a qualifying disability, or have end-stage renal disease.

Most people do not have to pay a premium for Medicare Part A.

Medicare Part A Covers:

◾Inpatient hospital care,
       including semi-private
       rooms, meals, general
       nursing, and drugs
       administered during a
       hospital stay

Medicare Part A - Hospital Insurance

Medicare Part A Covers:

◾Skilled nursing care in
      a Medicare-certified
      skilled nursing facility
      for up to 100 days per
      benefit period

◾Hospice care

◾Home health care

Does not cover: Prescription drugs, eyeglasses, dental care, long term care.

Medicare Part B - Medical Insurance

Medicare Part B Covers 80% of the cost of the following medically necessary services and supplies:

◾doctor visits
◾outpatient care
◾diagnostic tests
◾preventive services
◾durable medical
      equipment
◾certain vaccines,
      including the annual flu
      shot and the COVID-19
      vaccine

Medicare Part B - Medical Insurance

◾mental health services,
     including individual and
     group therapy, as well as
     outpatient substances
     abuse treatment 
◾preventive services, such
     as mammograms,
     colonoscopies, and
     prostate cancer
     screenings, at no cost to
     the patient

As of 2023, there is a deductible of $226 you must pay before Medicare begins to cover your expenses under Part B.

Medicare Part C - Medicare Advantage

Medicare Part C (Medicare Advantage) came into being as a result of the Medicare Prescription Drug Improvement and Modernization Act of 2003

◾You may choose a 
      Medicare plan instead of
      joining Original Medicare
     directly.
◾Part C plans provide all
      the same benefits of
      Original Medicare, except
      they are provided
      through a private
      network of providers.

Medicare Part C - Medicare Advantage

◾Medicare Advantage
      plans frequently offer
      additional benefits in
      addition to the basic
      Original Medicare
      benefits.
◾Some Part C plans are
      available with zero
      premium.
◾Members are
      generally limited to
      in-network
      providers for non-
      emergency care.

Medicare Part C - Medicare Advantage

◾You must enroll in
      Part A and Part B in
     order to enroll in Part C.
◾Some Part C plans
      include prescription
      drug coverage. Some
      don't.
◾You should not enroll
      in Medigap and
      Medicare Advantage
      at the same time.

Medicare  Advantage

Some Medicare Advantage Plans now include supplemental benefits.

These are benefits not covered under Original Medicare.

◾Vision and hearing
       services
◾Meal assistance and
      grocery delivery
      services
◾Transportation (to other
      than medical
      appointments)

Medicare  Advantage

◾Home air cleaning and
      carpet shampoo
      services for people
      with respiratory
      diseases
◾Home modification
◾In-home/caregiver
      support 

...and more

Some supplemental benefits may not be available in all areas.

Premium may be required.

Medicare  Part D - Prescription Drugs

◾Part D is designed to
      help cover the cost of
      prescription drugs
◾Medicare Part D also
      came into being as a
      result of the Medicare
      Prescription Drug
      Improvement and
     Modernization Act of
     2003 (MMA)
◾Available to all
      beneficiaries enrolled
      in Part A and B

Medicare  Part D - Prescription Drugs

◾Coverage includes
      both brand-name
      and generic
      medications
◾Some Part C plans
      include prescription
      drug coverage
◾Higher-income 
      Part D enrollees
      may be required to
      pay more under
      IRMAA rules

Medicare  Supplement Insurance 

◾Medicare supplement
      insurance (Medigap) is
      private health insurance
      designed to supplement
      Medicare Parts A and B.
◾Not part of Medicare
      itself. Instead, Medigap is
      a type of private
      insurance standardized
      under Medicare
      regulations.
◾Medicare beneficiaries
      enrolled in Parts A and B
      can choose from ten
     different standardized
     Medigap Plans.

Medicare  Supplement Insurance 

◾Medigap covers out-
      of-pocket expenses
      for things that
      Medicare Part A and B
     don't pay, such as
     deductibles, co-pays,
     and coinsurance
     costs.
◾You don't need
     Medigap insurance if
     you have Medicare
    Advantage insurance
    and vice versa.  

Why Own Medigap Insurance?

Original Medicare doesn't cover all costs and without additional protection, Medicare beneficiaries still face the risk of significant out-of-pocket costs in the form of deductibles, copays, and coinsurance.

◾The Part A deductible is
      $1,600 per benefit period,
      as of 2023.
◾The Medicare
      beneficiaries must pay
      $400 per day for hospital
      stays for days 61-90.  

Why Own Medigap Insurance?

◾For 91 days and beyond,
      Medicare beneficiaries pay
      $800 coinsurance for each
      day.
◾The Part B deductible is $226
      as of 2023.
◾Part B only pays 80% of your
      physicians, lab, and durable
      medical equipment costs.
      Medicare beneficiaries are
      still responsible for 20% of
      those costs.
◾These are huge financial
      risk for most people. But for
      a relatively small,
      predictable monthly
      premium, a Medigap policy
      can step in to cover nearly
     all your out-of-pocket costs.

Read our Exclusive Medigap "How To" Guide

Get Help With Your Medicare Strategy

Most people need either Medigap, a Medicare Advantage Plan, or a healthsharing plan like Medi-Share  65+ to protect themselves against the high cost of healthcare in retirement.

It's tough to keep track of it on your own as there are hundreds of plans and carriers out there and they keep changing every year.

For zero additional cost, you can get professional expert help with your Medicare strategy.

Get Help With Your Medicare Strategy

Click here to make an appointment.

Your Medigap Advisors Personal Benefits Manager can help you go through all your options, and help you select the best plan for your individual needs.

Even outside Open Enrollment.

Consultations are free.