Hospital Stays
Medical Coverage
Medicare Advantage
Prescription Drugs
Medicare Part A, also known as hospital insurance, covers costs associated with inpatient hospital stays, care in a skilled nursing facility, some home health care services, and hospice care. Here’s a closer look at each of these services:
Most people don’t pay a premium for Part A if they or their spouse have paid Medicare taxes for at least ten years (40 quarters). Those who don’t meet this requirement can purchase Part A, with premiums based on the number of quarters taxes were paid.
Medicare Part B, or medical insurance, covers outpatient care, preventive services, and other health services not covered by Part A. Key services covered by Part B include:
Part B has a monthly premium, an annual deductible, and generally covers 80% of the cost of covered services. Premiums may be higher for those with higher incomes, and financial assistance is available for those with limited incomes.
Medicare Part C, or Medicare Advantage, is an alternative to Original Medicare (Parts A and B) provided by private insurance companies approved by Medicare. These plans often include additional benefits like dental, vision, hearing, wellness programs, and prescription drug coverage.
Medicare Advantage plans typically have lower premiums and may offer additional benefits, but you’ll still pay the Part B premium and any cost-sharing amounts specified by the plan. Each plan is different, so it’s important to compare options carefully.
Medicare Part D provides coverage for outpatient prescription drugs. Offered through private insurance companies, Part D plans can be stand-alone or part of a Medicare Advantage plan with drug coverage (MAPD).
Each Part D plan has a formulary, or list of covered drugs, organized into tiers. Lower tiers typically include generic medications, while higher tiers include brand-name and specialty drugs. Your costs will depend on the drug tier and whether you’ve met your deductible.
Part D plans also have four coverage phases: Deductible Phase, Initial Coverage Phase, Coverage Gap (Donut Hole), and Catastrophic Coverage. Your out-of-pocket costs will vary depending on the phase you’re in when you pick up your prescriptions.
Hospital Stays
Medical Coverage
