When your Original Medicare Plan kicks in, it’s time to make some other decisions relative to your health. Being informed about your options can help you make a better decision. Medicare is a national health insurance program for individuals ages 65 or older, individuals under the age of 65 who have been declared disabled, or individuals with end-stage renal disease (ESRD). There are approximately 43 million elderly and disabled Medicare-eligible beneficiaries in the U.S. today.
Medicare is broken down into 4 parts: Medicare Part A, Medicare Part B, Medicare Part C or Medicare Advantage, and Medicare Part D.
Medicare Part A is the Original Medicare. You are automatically enrolled in the Original Medicare Plan which is managed by the federal government. Medicare Part A is the hospital insurance. It covers inpatient hospital care, inpatient care in a skilled nursing facility, home health care, and hospice care. You don’t usually have to pay a premium for Part A because the individual paid Medicare taxes while working.
Medicare Part B is a medical insurance offered by the federal government to eligible beneficiaries. Medicare Part B covers physician services, non-physician services, diagnostic tests, lab services, and ambulance transportation. Preventative care is also covered by Part B. Most people have to pay a premium for Part B.
Medicare Part C, or Medicare Advantage is a combination of Part A and Part B. Medicare Advantage plans are private health plans provided by private insurance companies. Part C is an alternative to Original Medicare and offers extra benefits. Part C plans include Medicare Health Maintenance Organization (HMO), Medicare Preferred Provider Organization (PPO), Medicare Private Fee for Service (PFFS), and Medicare Medical Savings Account (MSA).
Medicare Part D is a prescription drug coverage that helps pay for outpatient prescriptions drugs. You can either add Part D to your Original Medicare Plan or join an HMO or PPO that includes Part D coverage.
Just like choosing health insurance, Medicare insurance should be tailored to your needs. You can choose a plan based on premiums and out of pocket costs, additional benefits, whether referrals are needed, and whether the doctor you currently have is in network or out of network. After you have researched and gathered all the information necessary to make an informed decision, it is then time to choose from a variety of plans that suit your needs.