The A, B, C, & D’s of Medicare
Original Medicare pays for many, but not all, healthcare services and supplies. A Medigap policy, sold by private insurance companies, can help pay some of the healthcare cost (“gaps”) that , Like co-pays, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that original Medicare doesn’t cover, like medical care when you travel outside the US. If a Medicare beneficiary has original Medicare, and they buy a Medigap policy, both plans will pay their share of Medicare–approved amounts for covered healthcare cost. Medicare doesn’t pay any of the cost for a Medigap policy.
Every Medigap policy must follow federal and state laws designed to protect the beneficiary, and it must be clearly identified as “Medicare Supplement Insurance.” Medigap insurance companies can’t sell and Medicare beneficiary only a standardized Medigap policy identified in most states by letters Plans A through N. All plans offer the same basic benefits but some plans offer additional benefits, so the beneficiary can choose which one meets their needs.
Every Medigap policy must follow federal and state laws designed to protect the beneficiary, and it must be clearly identified as “Medicare Supplement Insurance.” Medigap insurance companies can’t sell and Medicare beneficiary only a standardized Medigap policy identified in most states by letters Plans A through N. All plans offer the same basic benefits but some plans offer additional benefits, so the beneficiary can choose which one meets their needs.
Medicare Supplement Plans
- Medicare Supplement Plan A
- Medicare Supplement Plan B
- Medicare Supplement Plan C
- Medicare Supplement Plan D
- Medicare Supplement Plan F
- Medicare Supplement Plan HDF
- Medicare Supplement Plan G
- Medicare Supplement Plan HDG
- Medicare Supplement Plan L
- Medicare Supplement Plan M
- Medicare Supplement Plan N
PART A Monthly Premium
You usually don’t pay a Part A (hospital insurance), monthly premium, if you or your spouse paid Medicare taxes while working. However, if you or your spouse did not pay Medicare taxes you could pay cost up to $505 for your Part A premium.
PART A Hospital
Part A Cost associated with hospital confinement
Hospitalized Your Responsibility
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Skilled Nursing
Confinement Your Responsibility
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PART B Medical
PART B Deductible $240
Medicare Pays
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Beneficiary Pays
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PART B Medical Premium
You pay a premium each month for Medicare Part B (Medical Insurance). Most people will pay the standard premium amount. However, if your adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay more.
If you are married with income higher than $85,000 and filed a separate tax return from your spouse; should contact Social Security for the exact amount of their monthly premium adjustment.
Part C (Medicare Advantage)
A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.
If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).
Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non‑emergency or non-urgent care). These rules can change each year.
Different Types of Medicare Advantage Plans
If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).
Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non‑emergency or non-urgent care). These rules can change each year.
Different Types of Medicare Advantage Plans
- Health Maintenance Organization (HMO) Plans
- Preferred Provider Organization (PPO) Plans
- Private Fee-for-Service (PFFS) Plans
- Special Needs Plans (SNP)
Part D (Prescription D Plan)
Medicare prescription drug plans are available only from private insurance companies approved by Medicare. Electing not to get Part D coverage when you were first eligible will result in a penalty added to your premium for every month your were without creditable drug coverage.
In order to get Medicare Prescription drug coverage, you must;
In order to get Medicare Prescription drug coverage, you must;
- have Medicare Part A and/or Part B,
- Live in the Plan's service area
- Enroll in a Medicare-approved prescription drug plan (PDP) or Medicare Advantage with Prescription Drug (MAPD)
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