Everything you need to know about Parts of Medicare

Listen to this article

The US government provides Medicare, which is federal health insurance coverage, to pay for a verity of healthcare products and services to its citizens. Medicare comes under the supervision of two departments that are Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health & Human Services (HHS).

The beneficiaries of Medicare are mostly senior citizens of age 65 years and above. In some cases, adults can get Medicare benefits, too, such as Lou Gehrig’s disease. Permanent disability also makes the patient eligible for Medicare irrespective of age.

Medicare program has been divided into four parts. While Part A and B are often considered Original Medicare, Part C, or Medicare Advantage is private health insurance. Medicare Part D provides cover for prescription drugs.

Different Parts different coverage

Medicare Part A

Medicare Part A provides financial support for inpatient hospital care, limited time in skilled nursing care, hospice care, and limited home health care services. Most of the Medicare Part A beneficiaries are not obliged to pay any monthly premium to avail coverage. It is also known as premium-free Part A. In general cases, if you have paid Medicare taxes while working for at least ten years, you will be eligible for premium-free Part A. In case you did not pay Medicare taxes, you have to pay a monthly premium. It does not provide full coverage of the medical bill, and the beneficiary has to pay a part of the payment.

Medicare Part B

It is medical insurance that covers a variety of non-hospital expenses such as blood tests, diabetic screening, outpatient hospital care, doctors’ visits, and more. To get this cover, you pay a monthly premium as a part of Original Medicare. If you have a higher income, the premium will be higher. There is another program by the government called Medicaid, which provides Medicare Part B cover for low-income beneficiaries. Every year you have to pay deductible till it starts. After the required age for Medicare, you will end up paying only 20% of the total medical bill. It clears a full invoice for a variety of lab tests requested by your doctor.

Medicare Part C

Non-government insurance companies offer it via CMS. It is considered an alternative to Original Medicare. Enrolling to Part C or Medicare Advantage plan is not mandatory. To become eligible for this plan, you have to obtain Medicare Part A and B.

Medicare Part D

Medicare Part D provides financial assistance for prescription drugs. It is a sand-alone insurance cover provided by private insurance companies like Medicarerx. The monthly fee is different among the beneficiaries depending on their medical bills. A part of the prescription drug invoice will be cleared by you and the rest by the insurance company.

If you are not eligible for Medicare because of limited income, you can opt for Extra Help Plan, which offers financial support for the monthly premium, copayment, deductibles, and coinsurance. The government has introduced several plans to cater to the needs of senior citizens and disabled in the country. Opting for these plans wisely will make your life easier.