If you are turning 65 but are unsure of what all Medicare covers, we have you covered.
Medicare is divided into four parts, each part covering a slew of different healthcare services. It’s important to differentiate each part’s coverage to avoid enrolling in a plan that does not offer the coverage you need.
Medicare Part A
Medicare Part A is hospital insurance that covers inpatient services, such as:
- Hospital visits
- Blood transfusions
- Hospice
- Home healthcare
- Skilled nursing facility care
Many receive premium-free Part A because they have paid Medicare taxes for ten years or more. You can also receive premium-free Part A if you:
- Receive retirement benefits
- Are eligible for retirement benefits
- Received disability for 24 months or more
- Have End-Stage Renal Disease (ESRD)
- You or your spouse had Medicare-covered employment through the government
Medicare Part B
Medicare Part B is medical insurance that covers outpatient services, such as:
- Doctor visits
- Lab work
- Diagnostics
- Imaging
- Surgeries
- Ambulance services
- Preventative care
- Mental health services
- Durable medical equipment
- Chemo
- Radiation
- Outpatient prescription drugs (but very limited to what is covered)
Unlike Part A, you cannot receive premium-free Part B. However, you can combine your Part A and Part B coverage to form what is known as Original Medicare. If you receive premium-free Part A, then you will only have to pay the Part B premium.
Medicare Part C
To qualify for a Medicare Advantage Plan, you must first be enrolled in Original Medicare. Medicare Advantage Plans are required to provide the same coverage as Original Medicare. However, some plans offer additional coverage, such as:
- Routine dental, vision, and hearing exams
- Prescription drug coverage
- Gym memberships
- Wellness and nutritional programs
- Other ancillary services
Medicare Part D
Medicare Part D provides prescription drug coverage as a standalone plan that can be bought with Original Medicare, or it can be an included benefit with a Medicare Advantage Plan.
Part D is required to cover at least two drugs in each drug category, but the plan can choose which drugs of those categories are covered. Keep in mind that each carrier and plan will have a different formulary list.
Need Help Deciding?
If you are still unsure which part of Medicare to enroll in, reach out to Midwest Medigap today. We will go over each part in more detail and help you determine what your coverage needs are.
