Learn The ABC and D's of Medicare
Medicare Part A (Hospital Insurance)
Helps Cover
Inpatient Care in a Hospital
Inpatient Care in a skilled nursing facility (not custodial or long-term care)
Hospice Care
Home Health Care
Usually, no premium for Part A
Copayments, coinsurance ,or deductibles may apply for each service.
Copayments, coinsurance ,or deductibles may apply for each service.
Medicare Part B (Medical Insurance)
Helps Cover
Services from doctors and other healthcare providers
Outpatient Care
Home Health Care
Durable Medical equipment (wheelchairs, walkers, hospital beds, CPAP supplies, and other equipment)
Mental Health Services
Many preventative services such as screenings, shots, vaccines, and yearly wellness visits.
Monthly premium (Can increase or decrease yearly as determined by Medicare)
Copayments, coinsurance, or deductibles may apply for each service.
Copayments, coinsurance, or deductibles may apply for each service.
Medicare Part C (Medicare Advantage)
Medicare Advantage is a Medicare-approved plan available through private companies that must follow rules set by Medicare. These plans offer an alternative to Original Medicare for your health and drug coverage. These plans typically combine Part A, Part B, and in most cases Part D (Drug coverage) into one plan.
Plans may have lower out-of- pocket costs than Original Medicare
Plans may offer extra benefits that Original Medicare doesn’t cover such as dental, vision, and hearing services
Specialized Part C plans are available for beneficiaries who receive financial assistance from the state or have certain chronic health conditions.
Medicare Part D (Prescription Drug Coverage)
Medicare drug coverage (Part D) helps pay for prescription drugs you need. Even if you don’t have any prescription drugs now, beneficiaries should consider getting Part D coverage. Medicare drug coverage is optional and is offered to everyone with Medicare. If you choose to not have drug coverage when you are first eligible and do not have other creditable prescription coverage, such as through an employer, the VA (Veterans Administration),or qualify for Extra Help (Financial assistance to pay for drugs), you will likely pay a late enrollment penalty if you enroll in a drug plan at a later date.
Part D plans are available through private insurance companies and can be obtained in two ways.
Stand-alone drug plan or PDP. Can be paired with original Medicare. You must have Part A and/or Part B to join a stand-alone Medicare drug plan.
Medicare Advantage Plans (Part C) or other Medicare health plans that include drug coverage as part of that plan.
Deductibles, coinsurance,and copays may apply.
It's important to note that while Medicare provides coverage for many healthcare services, it does not cover everything. There may be out-of-pocket costs associated with each part of Medicare, such as deductibles, coinsurance, and copayments.
With 10 years of industry experience, my role is to help clients navigate the complexities of Medicare and choose the right coverage for their unique healthcare needs and budget.
With 10 years of industry experience, my role is to help clients navigate the complexities of Medicare and choose the right coverage for their unique healthcare needs and budget.
Reference
Every year the Center for Medicare & Medicaid Services (CMS) sends a publication to Medicare beneficiaries titled Medicare & You. This booklet contains the most up-to-date information regarding Medicare for that year. I frequently refer to it and that is where some of the information here was obtained. This book is state specific. In the back, is basic information about the different Medicare Advantage and Part D drug plans available in Wisconsin. Another valuable resource is to visit the Medicare website at www.medicare.gov
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