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1-833-4Med-Bob

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What are The Parts of Medicare?

There are 4 parts of Medicare: Parts A, B, C, and D.

The 4 parts of Medicare provide coverage for different service:

Learn About the Different Parts of Medicare

  • Medicare Part A
  • Medicare Part B
  • Medicare Part C
  • Medicare Part D

The premium cost of Medicare Part A depends on the number of quarters you worked. Most people have worked 40 quarters or more, so Part A premium cost is zero. The Part A deductible is $1484 in 2021 for each benefit period of 60 days or less.

For example, you become a hospital inpatient on January 1, 2021 and pay $1484 deductible. Then 60-days later on March 2, 2021 a doctor admits you as a hospital inpatient and you pay $1484 deductible again. Therefore, the worst case scenario a Medicare beneficiary goes in and out of the hospital 6 times in the year and pays maximum $8,904 total in Part A deductibles.

To avoid the expensive cost of multiple hospitalizations, you could buy a Medicare Supplement Plan by calling Senior Healthcare Direct at 1-855-368-4717, TTY 711, or get your quote.

Medicare Part B covers the following services:

  • Medical outpatient services for stays at any hospital or medical facility for less than 24 hours. For example, a stay that occurs overnight but for less than 24 hours is outpatient service.
  • Preventive services to prevent illness such as seasonal flu-shot and annual wellness visits.

Medicare outpatient coverage includes:

  • Ambulance Service  – transportation to a medical facility.
  • Doctor Visits – anytime to see your primary doctor or specialist.
  • Mental Health – psychotherapy and counseling to treat conditions such as anxiety and depression.
  • Durable Medical Equipment – devices that assist with your medical conditions. For example, blood sugar monitors, oxygen equipment, and wheelchairs.

Medicare preventive coverage includes:

Preventive services cover screening tests that help detect health conditions at early stages when treatment is most effective. If you qualify, you many pay nothing for the following preventive screening tests:

  • Nutrition Therapy Service – you pay nothing if you have diabetes or kidney disease.
  • “Welcome to Medicare” preventive visit – you pay nothing as long as the doctor does not perform additional tests or services.
  • Yearly Wellness Visit – available every 12 months as long as the doctor does not perform additional tests or services.

To receive Part B coverage you need to pay a monthly premium. In 2021, the standard premium for Part B is $148.50.

Medicare Part C is an alternative to Original Medicare and covers Part A (Hospital Insurance) and Part B (Medical Insurance). Part C is also known as a Medicare Advantage (MA) plan.

MA plans often include Medicare Part D prescription drug coverage. Moreover, many MA plans include extra benefits not covered by Original Medicare. For example, MA plans may include dental, vision, and hearing. Some MA plans even include gym memberships such as Silver Sneakers! MA plans are offered through a network of healthcare providers HMO or PPO.

To enroll in Medicare Advantage plan (Part C) you must first be enrolled in Part A and Part B. Most Medicare beneficiaries pay no premium for Part A. However, beneficiaries new to Medicare will have to pay Part B monthly premiums. Furthermore, you may need to pay a monthly Part C premium.

Part D saves you money on prescription drugs. Specifically, it reduces your cost for brand-name and generic drugs. For example, rather than paying the full retail price for medications, you only pay small copayments with Part D.

You must have either Part A or Part B to join a stand-alone Part D drug plan with Original Medicare. However, you must have both Part A and Part B to join a Medicare Advantage (Part C) plan.

All stand-alone Part D drug plans have a monthly Part D premium. The amount you pay in 2021 depends on the income reported on your 2019 tax return. Some Part D plans have an annual deductible which can not be more than $445 in 2021. However, other drug plans may have little or no deductible.

After the out-of-pocket deductible, you pay either a copay or coinsurance for each prescription drug. For example, you may pay less for drugs in tier 1 and more for drugs in tier 2.

In 2021, you enter the donut hole after your plan spends $4,130. Then you pay no more than 25% coinsurance for the plan’s covered brand-name and generic prescription drugs. After total out-of-pocket drug costs are $6,550, you exit the donut hole.

When does Medicare coverage start?

Medicare coverage may start the first day of the month you turn 65. For example, if your birthday is 10/10/1948, your Medicare will start 10/01/2013. However, if your birthday is on the first of the month, your Medicare will start a month before your birth month on the first. For instance, if your birthday is 10/01/1948, then your Medicare will start 09/01/2013.

You may have a different Medicare start date if you delay Medicare coverage.

Medicare Parts coverage

How do I Pay for Medicare?

Discover the easy way to pay your Medicare premiums. Medicare Easy Pay is a free, electronic payment option. It automatically deducts your Medicare premium from your bank account each month. In other words, it automatically pays your Medicare premiums every month and removes the burden of you paying it yourself.

What is Medicare Coinsurance?

Coinsurance is your share of insurance costs after you pay the deductible. For Medicare Parts A and B your coinsurance cost is 20%. For example, after you pay the Part A deductible you owe 20% of the hospital bill.

Hospital Coinsurance in 2021

What is a Medicare Deductible?

Medicare deductible is an amount of money that you are require to pay before your insurance plan will pay anything towards your bills.

Deductible Examples

Common questions about signing up for medicare

What is my Medicare claim number?

Your Medicare Claim Number used to be your social security with a letter after it. However, your social security number on Medicare cards were replaced with a new Medicare Number to prevent identify theft and taxpayer fraud.

Each new Medicare Number is unique to each beneficiary, has 11 characters, and composed of numbers and uppercase letters. It excludes the letters (S, L, O, I, B, Z) which could be interpreted as numbers.

Is Medicare free?

If you paid Social Security Tax for at least 40 quarters (10 years) and your net earnings amount equaled the yearly maximum of 4 credits, you pay no Medicare Part A premiums.

However, Medicare Part B has a premium is based on your income from the prior two years. The standard Part B premium is $148.50 in 2021.

What is not covered by Medicare Part A and Part B?

The following is not covered by Medicare Part A and Part B: Long-term care, Routine dental or eye care, dentures, cosmetic surgery, hearing aids/ exams, routine foot care.

Common questions about medicare

Your Medicare Claim Number is the number that Medicare uses to file your claims.

Medicare Part A is free (no premium) for most people. However, Medicare Part B has a premium based on your income from the prior two years. In other words, if the current year is 2021, then Medicare Part B is based on your income from 2019.

The following is not covered by Medicare Part A and Part B: Long-term care, Routine dental or eye care, dentures, cosmetic surgery, hearing aids/ exams, routine foot care.

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