MEDICARE

What are the parts of Medicare?

PART A (HOSPITAL)

Helps cover the following (including, but not limited to):

  • Inpatient hospital care
    • Semi-private room
    • Meals
    • Drugs, supplies, equipment
    • Lab and x-ray
    • Operating room/recovery services
  • Blood transfusions (hospital or skilled nursing facility
  • In and out rehabilitation services after a qualified inpatient stay
  • Some in-home skilled nursing care (restrictions apply)
  • Hospice

Part B (Medical)

Helps cover the following (including, but not limited to):

  • Doctor visits in and out of hospital
  • Preventative services
    • Flu shots
    • Mammograms
    • Annual physical
    • Many more!
  • Lab tests (Blood work)
  • MRI, CT scans, X-rays, & other diagnostic tests
  • Outpatient Physical, Occupational, & Speech/language therapy
  • Diabetes screening, education, & supplies
  • Mental Health Care
  • Durable Medical Equipment (example: wheelchair, crutches, prosthetics)
  • Ambulatory Surgical Center Services
  • Ambulance (ground or air), Emergency Room, & Urgent Care

Part D (Prescription drug coverage)

  • Provided by private insurance companies overseen by Medicare
  • Helps cover cost of prescription drugs
    • Generic
    • Brand
    • Specialty
    • Vaccines & Shots
  • Can be a separate plan
    • Example:  Medicare Supplement plan and a Prescription Drug Plan
  • Can be included in a Medicare Advantage plan
    • Example:  Medicare Advantage plan that covers both medical and prescription drugs all in one plan.
  • Premiums, Co-pays, & Deductibles can be subsidized for eligible beneficiaries.
  • Prescription brands covered, co-pays, co-insurance, premiums, deductibles, and pharmacy networks are different between plans.

PART C (Medicare Advantage)

  • Combines Medicare Parts A & B. Most plans also include Part D and extra benefits into one plan often with no additional premium.

    • Plans often have no to low premiums
    • Most plans offer some or all of the extra benefits
      • Dental
      • Eye glasses & Hearing Aids
      • Free over the counter supplies
      • Gym membership
      • Wellness programs
      • Transportation
      • 24 hours nurse hotline
      • Food allowance
      • Part B premium reduction
    • Have network of providers
    • Coordinated Care

Your Medicare options

here are 7 coverage combinations that a Medicare beneficiary with Parts A & B can elect to be covered for their health care needs. See Below.