THE A – B – C’s (AND D) OF MEDICARE

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Let’s face it… Health Insurance has always been complicated. But more often than not, you got your health insurance from work and you had limited options that your employer offered. Or, you went to a professional – an insurance agent – who knew the ins and outs of Health Insurance. Regardless of the route by which you got insurance, your options were laid out for you and easy to understand.

Now it’s time for you to enroll in Medicare. Easy – peasy, right? Well, that’s what most people think, and once they start, they realize it’s not as simple as they thought. So let’s look at the ABC’s of Medicare, and throw in a D just for more confusion.

Medicare has three primary Parts – A, B, and D. D you say – what happened to C? We’ll get to that in a minute. Most people are eligible for Medicare once you turn 65, but in some cases you can qualify before you’re 65th birthday. You need to be a citizen or a green card holder who has lived in the. US for 5 years.

Now lets talk about the Parts of Medicare.

Part A is Hospital and Inpatient Benefits which includes inpatient care in hospitals, skilled nursing facilities, Hospice care and Home Health care.

Part B is Doctor and Outpatient benefits such as services from doctors and other health care providers, outpatient services and home health care, durable medical equipment and many preventive services

Part D is prescription drug coverage – pretty self-explanatory.

Part C is Parts A, B and D, all rolled into a single plan called a Medicare Advantage plan and these are run by Medicare approved private insurance companies. While traditional Medicare parts A & B will let you go to any doctor or facility, Part C Medicare advantage plans are typically HMOs or PPOs which require you to stay within their networks to keep costs in line. These are the “$0 premium” plans you see advertised during the open enrollment periods.

One thing to understand, regardless of what you hear about Medicare for all, MEDICARE IS NOT FREE. Each of the parts I mentioned above has a cost associated with it. For most folks, Medicare part A is free – why… because most folks have paid into Medicare through their jobs. If you worked 40 quarters and paid into Medicare, your Part A is free. If you didn’t, your Part A premium would be just under $500 per month (2020). 

Part B has a monthly premium of $144.60, which may be even more depending on your income. Check out my article about IRMAA for all the details on that. And, Part B only covers 80% of the charges. You’ll need a supplement to cover the balance. (Are you starting to see why you might need a pro to help you out?)

Part C Premiums start at $0 but will increase depending on the type of Medicare Advantage plan you select. The “richer” the benefits and coverage, the more the premium will cost. In addition, you’ll have co-pays for many visits and services that you won’t be paying with traditional Medicare and a supplement.

Part D plans again have a variety of costs depending on the coverage, the pharmacy you use, and the formulary (list of drugs covered). Those premiums can be as low as $7 or run into the hundreds. Again, all the more reason for you to use a pro.

So that’s the 4 parts of Medicare in a brief nutshell. Confused? Feel like you’re in a maze? You don’t have to be. 

If you have any questions about Medicare or need any help enrolling, just reach out to me at any time… drop me an email at Marty4Medicare@gmail.com or just  click here to download my digital business card and give me a call!

Until next time…. Stay safe!

Marty Silbernik Agent, United Insurance Experts

(954) 993-9339 (Direct)
6401 Congress Ave., Suite 205, Boca Raton, FL 33487 
marty@unitedinsuranceexperts.com 
www.unitedinsuranceexperts.com

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