What is Original Medicare Parts A & B?
It has finally arrived! You have looked forward to retirement for many long years of work. You feel your age at times, but you are happy to be able to finally claim social security and live out your golden retirement years.
Living through seven decades, you’ve experienced many changes in yourself and in the world. The information you are reading right now was probably found with a google search instead of looking up words in an encyclopedia.
We know that you have many questions. Do you need Medicare supplement for your insurance? Do you know who qualifies for Medicare or what is needed to apply? Being informed and prepared can help get what you need and avoid extra fees. Some of which can put a damper on your golden season.
We are here to provide the information that you need to define Medicare. We will help you to understand Medicare parts a & b, the other Medicare parts, and explain who qualifies for Medicare.
A & B
Understanding Who's eligible for Medicare
Original Medicare Parts A & B are available to every US citizen or legal resident age 65 or older.
If you are enrolled in Social Security benefits, you will automatically be registered for Medicare Parts A and B. If you need to apply for Medicare, most people can do so online. There are instances that you will not be able to complete an application online. These include:
If you were not born in the US.
If your records have any differences that do not line up with your personal information.
If you have not worked over 10 years / paid into Medicare
Are you still working? Are you on your employers’ health insurance plan? You do not have to opt into Medicare. The purpose of Medicare coverage is for those who need to ensure they have insurance.
What does Original
Medicare (Parts A & B) cover?
Most Americans are not charged for Part A. This plan is of no cost to you if you have paid into Medicare. This time period of employment must be for at least 10 years or 40 quarters.
There is a monthly fee for Medicare Part B. This plan could be affected by your source of income prior to retirement or acceptance of social security. If you have begun receiving Social Security around your 65th birth month, payments may automatically be paid out.
Part A and Part B cover hospital and basic medical coverage such as going to the doctor. Your current health situation might dictate what you do and don’t need. Chart out what your medical map has been for the last few years.
Part A is seen as the hospital or in-patient portion of your Medicare.
It covers:
Hospital visit
You will have a deductible during this period. This will be covered through day 60 of your hospital visits.
Beyond 60 days in the hospital, you will be charged a daily fee.
This deductible resets every 60 days.
Skilled Nursing Staff
The first 20 days are covered under your premium.
If you use the assistance beyond 20 days you will be charged a daily fee.
Some home health care
Hospice Care
Part B is known as your medical coverage.
This plan covers:
Doctor Visits
Outpatient Services
Medical devices/equipment
Prescription Drugs that are administered professionally
Preventive Services
What are the other parts of Medicare?
(Part C, Part D, Medicare supplement "Medigap")
C & D
Part A and Part B are under the umbrella of Original Medicare. There are other Parts that will function as the additions you might have for insurance. For the areas that the Medicare Parts do not cover you can opt for Medicare Supplement Insurance.
Part C – This is also known as Medicare Advantage. You must be eligible and enrolled in Medicare Parts A and B.
Part D – Prescription Drugs coverage
Provides the benefits from Parts A and B under one plan and insurance provider.
Many Part C plans also include dental, vision and hearing programs.
Medicare Advantage normally offers prescription drug coverage.
Part C requires that you stay within the network of doctors. These are explained when you sign up for your Advantage plan.
Medicare Advantage many times have little to no monthly cost. The flip side is there will be higher deductibles and other out of pocket expenses.
Part D – Prescription Drugs coverage
Part D is specifically for prescription drugs. For individuals with Original Medicare this is a great additive to their insurance.
This portion of Medicare is additional and will have its own monthly payments and deductibles that must be met.
When you are no longer under your employer insurance plan, you need to keep documentation of your creditable coverage. If you do not present the notice of creditable coverage, you could receive late penalty fees.
Part F – Expired plan
Prior to January 1st of 2020 new enrollees were eligible for This Medicare plan is no longer an option if you became eligible after the first of 2020.
Medicare Supplemental – Private insurance.
This is also known as Medigap.
Provides the coverage to fill in the gaps left by your Medicare insurance.
There will be an associated monthly cost. Yet, it will lower your out-of-pocket cost.
Covers expenses for copayments, coinsurance and deductibles.
You must first have coverage under Medicare part A or part B.
What is NOT covered by Original Medicare?
Original Medicare covers the basic needs for those over 65 years of age, but it does not cover.
Dental
Vision
Hearing
Prescription
Cosmetic Surgery
Long Term Care such as nursing homes
Enjoy Your Medicare Benefits
Now that you understand a bit more about your Medicare coverage options, you can step into your retirement years fully prepared.
You’ve spent years working hard and paying into the program, claim your benefits from Medicare parts a & b and bask in the relaxation of your golden years.
Need help choosing the best plan for your health? Contact one of our licensed agents today to help you through the process.
The best part? The whole process is 100% free, with no obligation whatsever to enroll!