Medicare Part B
Part B helps cover medically necessary services like doctors' services, outpatient care, durable medical equipment, home health services, and other medical services. Part B also covers some preventive services. Check your Medicare card to find out if you have Part B.
•How Much Does Part B Cost?
If you have Part B, you pay a Part B premium each month. Most people will pay the standard premium amount. Contact Social Security to see what you have to pay.
•How Do I Get Part B?
Some people automatically get Part B. Visit Medicare.gov to learn how and when you can sign up for Part B.
•What Does Part B Cover?
To find out if Part B covers something specific, visit Medicare.gov to learn more about this coverage. Part B covers medically necessary services.
Medicare Advantage (Part C)
Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. When you join these plans, you still have all Medicare services (Part A and B) plan coverage but not under Original Medicare. The company must follow rules set by Medicare to offer these plans. In additions to the set rules of Medicare, the plan will also have rules for the services they provide. These rules can change each year. Be sure to review all areas of the plan before you join. You can't have a Medicare Supplement and a Medicare Advantage plan at the same time.
What Does a Medicare Advantage Plan Cover?
When you join these plans, you still have all Medicare services (Part A and B) plan coverage but not under Original Medicare. Not all Part C plans are the same. Each plan can have networks of providers (doctors, facilities, hospitals and more) for you to access. Be sure to know what the out-of-network provisions are in the plan you select before purchasing. They will also have different out-of-pocket costs that you will have to pay for when you use certain services. Check with the plan before you get a service to find out whether they will cover the service and what your costs may be. You must follow plan rules on how they manage the plan, for example, if you need a referral to see a specialist.
Many MA plans include Medicare prescription drug coverage (Part D). If the plan you choose doesn’t have a Part D, you will need to select a stand-alone plan. Be aware of this…If you’re in a plan that includes the Part D and you join a separate (stand-alone plan) Medicare Prescription Drug Plan, you’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare.
What are the Different Types of Medicare Advantage Plans?
Check with the insurance company authorized to provide plans in your area as to what is available. These are some of the plans offered: Health Maintenance Organization (HMO) Plans, Preferred Provider Organization (PPO) Plans, Private Fee-for-Service (PFFS) Plans and Special Needs Plans (SNP).
How Much Does a Medicare Advantage Plan Cost?
In addition to your Part B premium, you generally pay a monthly premium for the services included with your plan. Each Part C plan charges different out-of-pocket costs, you need to review this as well.
These are some of the costs:
Monthly plan premium, yearly deductible (or any additional deductibles); copayments or coinsurance for provider visits or services; type of health care services you need and how often you get them; and the plan’s yearly limit on your out-of-pocket costs for all medical services. Be sure to review your plan details for additional costs.
There are steps to follow to join, switch or drop a Medicare Advantage Plan. Review the details before you make a move.
Medicare Part A
Part A is hospital insurance that helps cover inpatient care in hospitals, skilled nursing facility, hospice, and home health care.
•How Much Does Part A Cost?
Most people don’t pay a Part A premium because they paid Medicare taxes while working. This is called "premium-free Part A."
If you aren't eligible for premium-free Part A, you may be able to buy Part A if you meet certain conditions. Check with Medicare to see what you are eligible to receive.
•How Do I Get Part A?
Some people automatically get Part A. Learn how and when you can sign up for Part A.
•What Does Part A Cover?
To find out if Part A covers something specific, visit Medicare.gov. In general, Part A covers:
◦ Inpatient care in hospitals (such as critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals)
◦ Inpatient care in a skilled nursing facility (not custodial or long term care)
◦ Hospice care services
◦ Home health care services
Medicare Prescription Drug Coverage (Part D)
Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare drug plan when you’re first eligible, and you don’t have other creditable prescription drug coverage, or you don’t get Extra Help, you’ll likely pay a late enrollment penalty. To get Medicare prescription drug coverage, you must join a plan offered by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.
There are two ways to get Medicare prescription drug coverage:
1. Medicare Prescription Drug Plans are also called Part D and PDP. These plans add drug coverage to Original Medicare and some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
2. Medicare Advantage Plans (like an HMO or PPO) or other Medicare health plans that offer Medicare prescription drug coverage. You get all of your Part A and Part B coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.
In either case, you must live in the service area of the Medicare drug plan you want to join. Be aware of this…If you’re in a Medicare Advantage plan that includes the Part D, and you join a separate (stand-alone plan) Medicare Prescription Drug Plan, you’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare.
Can I switch to another Medicare drug plan?
Each year, you have a chance to make changes to your Medicare prescription drug coverage for the following year. Review the guidelines on when you can do this.