What Should You Know About Medicare

Medicare is the health insurance program run by the federal government for people aged 65 and older. Younger people with disabilities may also qualify for Medicare plans.

Medicare consists of three types of coverage that include Medicare Parts A, B, and D.
Medicare Part A is the hospital insurance that helps with covering services such as hospital stays, hospice care, as well as home health and nursing facility care.

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Part B is the medical insurance that covers services such as outpatient care, preventive services, and services provided by doctors.

Part D, on the other hand, is the coverage for prescription drugs, which helps to cover many of the common prescription drug treatments.

How Much Do You Pay for Medicare?

Standard Medicare payments consist of premiums for Parts A and B. Medicare Part A is often referred to as the premium-free part of Medicare. This is because many people do not pay for this premium if they paid Medicare taxes during their working days.

To qualify for this premium-free Part A when you are 65 or over, you should have met the following criteria:

  • You are currently receiving Social Security or Railroad Retirement Board retirement benefits.
  • You or your spouse received Medicare coverage from a government employer.
  • You are eligible for Social Security benefits but have not yet filed for them.

If you do not end up qualifying for premium-free Part A, you can buy it and could pay up to $458 per month. If while working, you paid Medicare taxes for 30-39 quarters, you will pay a standard part A premium of $252 per month.

However, if you paid these Medicare taxes for less than 30 quarters, then you could have to pay a standard Part A premium of $458 per month. Unlike the premium for Part A, everyone is required to pay for the Part B premium, which is $144.60 for 2020.

Depending on the modified adjusted gross income reported on your tax return from two years ago, you might have to pay the standard premium and an additional charge called the Income Related Monthly Adjustment Amount (IRMAA).

Can You Apply for Different Medicare Plans?

When you enroll with Medicare, you can decide which coverage options work best for you. You could enroll in either an Original Medicare or a Medicare Advantage plan.

Original Medicare

With Original Medicare, you can obtain Medicare Parts A and B to cover hospital and medical insurance. As each year starts, you pay a deductible for the services for which you have enrolled during the year.

You also pay a coinsurance amount of 20% of the cost of the Medicare-approved service. You can also enroll in a separate plan for drug coverage, known as Medicare Part D.

According MedicareUSA Original Medicare does not cover all the costs of health care services and supplies. In fact, most prescriptions are not covered, and most people end up enrolling in Part D for drug coverage.

With Original Medicare, there is also no limit to what you pay for out-of-pocket costs every year.

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Medicare Advantage

Unlike Original Medicare, a Medicare Advantage plan bundles up Medicare Parts A, B and sometimes D. A Medicare Advantage plan generally provides certain benefits that are not covered by Original Medicare, such as coverage for vision, dental, and hearing services.

Medicare-approved private companies that participate in Medicare Advantage plans are governed by Medicare rules. Each month, Medicare pays these companies a set amount for the care they provide to customers.

The Medicare Advantage plans also set limits on what customers pay for out-of-pocket expenses, which protects you as a customer from having to pay unexpected costs.

To pay the lowest costs, you may have to obtain coverage from providers within the Medicare Advantage plan’s network. It could be more costly to obtain coverage from out-of-network providers.

Drug Coverage

If you need coverage for prescription drugs, it is advisable to enroll in Medicare Part D, which covers prescription drugs. To obtain this coverage, you must enroll in a Medicare drug plan or Medicare Advantage plan with drug coverage.

In general, coverage through Medicare Part D covers both generic and brand-name drugs. The costs in coverage will depend on whether the drugs are listed on your plan’s coverage, as well as which tier the drugs are classified.

Plans may also consider factors such as benefit phase of coverage and the type of pharmacy you use to receive your drugs. For example, it might be cheaper to obtain drugs at a preferred pharmacy since it could have agreed with your Medicare plan to provide drugs at a lower cost.

Editor
Editorial Staffs at Healthtian, A team of Writers.