Medicare Basics
3 Facts About Medicare
- Medicare covers U.S. citizens age 65 and older and people with certain disabilities.
- Medicare comes in 4 Parts: Parts A, B, C, and D. Medicare Parts A & B are administered by the government and are referred to as Original Medicare. Medicare Parts C & D are provided by private health insurance companies.
- Original Medicare only covers 80% of Part B services and there's no out-of-pocket limit; therefore, many people get Medicare Supplement Insurance plans to help pay for some of these out-of-pocket costs.
Medicare Part A
Medicare Part A, sometimes called Hospital Insurance, covers hospital and inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care.
In 2022, the deductible for Medicare Part A hospital care is $1,556 per benefit period*.
A benefit period, as described above, begins the day that you are admitted to the hospital and ends when you've been discharged for at least 60 days. If you have been out of the hospital for more than 60 days and are admitted again, a new benefit period begins.
* Per The Centers for Medicare & Medicaid Services (CMS) fact sheet on Nov 12, 2021.
Medicare Part B
Medicare Part B is optional and covers doctor and other health care providers' services and outpatient care. Part B also covers durable medical equipment, home health care, and many preventive services. In most cases, Original Medicare only covers 80% of Part B services. In order to qualify for certain private Medicare options, such as Medicare Advantage or Medicare Supplement Insurance (also called Medigap Insurance), you must be enrolled in Part A and Part B. The standard Medicare Part B premium in 2022 is $170.10 per month, and the 2022 deductible is $233.00 per year*. The Part B premium is based on your adjusted, household gross income. Together, Parts A & B are typically referred to as Original Medicare.
* Per The Centers for Medicare & Medicaid Services (CMS) fact sheet on Nov 12, 2021.
Medicare Supplement Insurance Plans (Medigap Plans)
Medicare Supplement plans also called Medigap plans, are offered by private health insurance companies to help pay for certain out-of-pocket costs associated with Original Medicare (Parts A and B).
Medicare Part C (Medicare Advantage)
Medicare Part C, also called Medicare Advantage or MA plans, is an alternative to Original Medicare. This type of plan is offered by private insurance companies and must provide at least the same basic benefits as Medicare Parts A & B but may also contain additional features and benefits such as prescription drug coverage.
Medicare Part D (Prescription Drug Coverage)
Medicare Part D covers prescription drugs for Medicare. Plans are offered by private insurers—not the federal government—and the details will vary based on insurance providers. In addition to Original Medicare, you can enroll in Part D coverage from a private, standalone Prescription Drug Plan or through a Medicare Advantage plan that includes it.
Medicare eligibility and enrollment
In order to qualify for Medicare coverage, you must be at least 65 years old and a U.S. citizen OR a permanent legal resident who has lived in the U.S. for at least 5 continuous years. You also may qualify if you are under 65 and have a certain disability. Some beneficiaries will be enrolled in Original Medicare automatically. If not, applicants can apply during certain enrollment periods.
Contact a Mayberry Advisors licensed insurance agent to discuss options to manage your healthcare.
