What Is Medicare - Facts You Need To Know

When starting Medicare it's important to know the difference between all the parts of Medicare.  Part A, B, C, and D.  You want to make sure you get the most out of Medicare and you find a plan that fits your needs as well.

The Basics of Medicare

​Medicare is a federal health program, administered by CMS (Centers for Medicare and Medicaid) which is a division of the U.S. Health and Human Services (HHS).  Most Medicare beneficiaries are senior citizens 65 and older.   However, adults with permanent disabilities and some approved medical conditions such as ALS may also be eligible for Medicare Benefits.

U.S. citizens are eligible to enroll by working and paying taxes for 40 quarters.  If you don't have the required amount of quarters you may still be eligible, but you will have to pay more.  

4 Parts of Medicare A,B,C and D

Medicare Part A covers inpatient hospital Care, limited time in a skilled nursing facility, limited home health services, and hospice care.  Think of this as your Hospital insurance.  Most beneficiaries don't have to pay a premium for this part.  If you worked your 40 quarters (10 years) and paid taxes Part A is free.   If you didn't you can still receive benefits for  Medicare Part A but you will have a premium.  

Be aware that Part A doesn't cover the full amount of your hospital bill, and you will be responsible for the difference.  There is also a deductible you have to pay before your benefits begin.   

Medicare Part B covers the non-hospital medical expenses.   Doctor visits, blood tests, X-rays, diabetic screening and supplies, and outpatient hospital care.   For Medicare Part B you have a monthly premium.  This premium for Original Medicare varies by income.  The fee is much higher for people in high income brackets.  For people in low income brackets who need help with coverage Medicaid is also available.  

Medicare Part B also has a deductible before your benefits kick in.  After that you are responsible for 20% of the bill.  

Medicare Part C commonly know as Advantage Plans.   These plans are offered by private insurance companies and are contracted through CMS.  The benefit package are an alternative to Original Medicare but to qualify for Medicare Part C you must still be enrolled in Original Medicare.  You still have to pay your Part B premium .

Medicare Advantage plans have to provide all the benefits of Original Medicare (except hospice) they can include additional benefits such as eye exams, hearing aids, and dental care.  Many Medicare Advantage plans also include prescription drug coverage.  These are called Medicare Advantage Prescription Drug plans.  

Medicare Part D is prescription drug coverage.  This is a stand alone plan through private insurance companies and the monthly fees vary between companies.   Open enrollment for Part D is October 15th through December 7th and these plans may change every year.  

Have questions or just need help Give Me a Call. 
Rob Davies
​800-254-5200