Medicare Basics: ABCDs and Supplemental Plans
What Is Medicare?
Medicare is the federal health insurance program for:
People who are 65 or older
Certain younger people with disabilities
People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
What Are the Different Parts of Medicare?
Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
For individuals (or spouses) who have paid 40 quarters into the Medicare system, Part A has no monthly premium. However, there is a deductible of $1600 per benefit period, which begins the day you're admitted as an inpatient in a hospital or SNF. The benefit period ends when you haven't gotten any inpatient hospital care (or skilled care in an SNF) for 60 days in a row.
If you go into a hospital or an SNF after one benefit period has ended, a new benefit period begins.
Medicare Part B (Medical Insurance)
Part B covers certain doctor's services, outpatient care, medical supplies, and preventive services.
For most individuals, the base monthly fee is $164.90 (higher for high-income earners). There is a $226 deductible for the year and then you’re responsible for 20% of the total cost.
Medicare Part C (Medical Advantage)
Medicare Advantage is a Medicare-approved plan from a private company that is an alternative to supplemental plans which bundles Parts A, B, and often D into an all-in-one plan with co-pays, networks, and in most cases extra benefits such as dental, vision, fitness, and hearing for typically lower monthly costs than a traditional supplemental plan.
Medicare Part D (prescription drug coverage)
Helps cover the cost of prescription drugs (including many recommended shots or vaccines).
Prescription coverage is administered by private insurance companies. There can be an overwhelming number of prescription plans to choose from. The right coverage for you is dependent on the prescriptions you take.
Medicare Supplemental Plans(Medigap)
Medicare Supplemental(Medigap) is a Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining healthcare costs, like:
Copayments
Coinsurance
Deductibles
There are numerous supplemental plans depending on the level of coverage. Supplemental plans do not include prescription coverage.