Medicare by Parts
Medicare has several parts. Medicare Parts A and B are the original components. Parts A and B are Federally provided coverage to help with medical expenses, generally for those who are 65 and older.
Medicare Parts C and D, along with Medigap, are supplemental coverage that can be purchased to complement original Medicare.
What is Medicare Part A?
Medicare Part A is health insurance for hospital-related expenses. It is provided by the United States government to citizens and legal immigrants over 65.
If you are over 65 and have worked for a least 10 years paying Medicare taxes, you qualify for premium-free Part A coverage.
You can still buy into Medicare Part A if you are over 65 but don’t qualify for the premium-free version. Additionally, certain disabilities can qualify you before the age 65.
What is Medicare Part B?
Medicare Part B is outpatient insurance. It is provided by the United States government to citizens and legal immigrants over 65.
Individuals who are eligible for premium-free Medicare Part A are also eligible to enroll in Part B.
Benefits of Medicare Part B include:
- Doctor’s visits
- Emergency ambulance services
- Lab work
- X-rays
- Outpatient surgeries
- Preventive services
- Medical equipment
Medicare Part C (Medicare Advantage)
Medicare Part C plans are often called Medicare Advantage (MA) plans.
These Medicare-approved private insurance plans are for people already enrolled in Medicare Part A and Part B.
They offer all the benefits of Medicare Part A and B, plus additional services for a premium.
Additional Benefits usually included in Medicare Part C
- Vision
- Dental
- Hearing
Prescription drugs are covered separately in Medicare Part D but may be packaged with the purchase of a Medicare Advantage plan.
What is Medicare Part D?
Medicare Part D provides prescription drug coverage that is supplemental to those with Medicare Part A and Part B.
Original Medicare doesn’t cover most of your medications. Part A covers drugs you get as a hospital inpatient only. Part B covers drugs you get as an outpatient, in very limited cases, like infusion drugs.
Medicare Part D covers a much wider of Prescription Drugs taken at home.
The drugs that are covered by a Medicare Part D plan and their pricing are listed in the plan’s formulary, which you can request before purchase.
What is Medigap (Medicare Supplement)?
Medicare Supplement, or Medigap, is additional private insurance that helps pay for the “gaps” in Medicare Part A and B.
Individuals with Medicare Part C (Medicare Advantage), cannot get a Medigap plan.
General Benefits of a Medigap plan
- Routine vision or dental care
- Hearing aids
- Eyeglasses
- Private-duty nursing
There are currently ten different types of Medigap plans, and each state approves a set of coverage options. These plans vary in their coverage, deductibles, and premiums. Choosing the right one can take a lot of research.
Differences between Medicare and Medicaid
Medicare and Medicaid are two separate, government-run programs. They are operated and funded by different parts of the government and primarily serve different groups. Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income.
Medicaid is a state and federal program that provides health coverage if you have a very low income.
If you are eligible for both Medicare and Medicaid (dually eligible), you can have both. They will work together to provide you with health coverage and lower your costs. Also know that while Medicare and Medicaid are both health insurance programs administered by the government, there are differences in covered services and cost-sharing. Make sure to call 1-800-MEDICARE or contact your local Medicaid office to learn more about Medicare and Medicaid costs and coverage, especially if you are a dual-eligible.