Original Medicare Program
The Original Medicare Program is made up of 4 Parts currently. But at any given time you will only be using either Part A, Part B, and Part D OR you will be using Part C. Let me break down what each of these are below:
MEDICARE PART A:
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Most of the time Part A doesn't cost you anything in terms of monthly premium as long as you have paid 40 quarters in the the Medicare system through you taxes while you were working.
If you do end up needing to use your beneifts, there is a large deductible that needs to be met before Part A starts paying benefits, but then you will be covered for the 1st 60 days after before you start to realize copays and coinsurance.
MEDICARE PART B:
Medicare Part B is outpatient medical coverage. Part B helps pay for medically necessary services performed on an outpatient basis that are needed to diagnose and treat a medical condition.
Visits to your Primary Care Physician, Specialists, Surgeries, lab work, and preventative services are all covered under Part B. There is a monthly premium that you would be responsible for that will be withdrawn directly from your Social Security check if you are drawing Social Security. Otherwise you would need to pay the premium 3 months at a time from your checking account.
There is a once a year deductible that you would have to meet before Part B pays anything, then it is a 80/20 split where you would be responsible for 20% of the costs of service. Part B is also deferrable in the event that you may be covered by an employee or group coverage of 20 people or more. When you initially take your Part B for the very first time, you are in the most powerful position you'll ever be in with respect to your Medicare benefits. JBA Insurance makes sure you understand why this is so important, as well as insure you know all of your rights & entitlements under Medicare.
MEDICARE PART C:
Medicare Part C is also called Medicare Advantage (MA or MAPD). It’s an alternative to Original Medicare. Medicare Advantage may include prescription drug coverage, along with other extra benefits. It is offered through private insurance companies, so you don’t enroll in it at the Social Security office or website. These are usually network plans such as HMO's and PPO's with copayments and coinsurance found all throughout the plan based on services rendered. If you have an MA plan then this becomes your Primary Insurance and Original Medicare gets set aside but you will still need to continue paying your Part B premiums. The 80%/20% split DOES NOT exist when you take a Medicare Advantage Plan.
MEDICARE PART D:
Medicare Part D is your prescription drug coverage. Part D coverage is available as a Stand Alone Option (PDP) or as part of a Medicare Advantage plan (Part C). Part D plans are offered by private insurance companies contracted and approved by Medicare. Regardless of whether you do or do not take any medications, YOU MUST ENROLL in a Part D Medicare approved drug plan, whether it be through a MedAdvantage Plan, or a stand alone drug plan. Your refusal to enroll in a credible Part D drug plan, may result in penalties down the road.
To learn more about the options of having Original Medicare with a Supplement and Drug Plan OR choosing a Medicare Advantage plan, please click one of the buttons below. You can also always press the "Click to Call" button above to reach us today!
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