There are four different parts to Medicare coverage. The four different parts are parts A, B, C, and D. Part A covers hospital related expenses. Part B covers medical expenses. Part C is offered through private insurance companies and combines coverage from part A, B, and sometimes D. Part D is stand-alone coverage from prescription drugs. One of the common misconceptions about Medicare is that it is completely free. This guide goes into more detail about everything the different parts of Medicare cover as well as the costs.
Medicare Part A
Medicare Part A is a basic insurance plan offered by Medicare. It covers hospital related expenses. There is little to no cost for Part A coverage for most seniors. Most people do not have monthly premiums with Part A coverage. The deductible for Part A is $1408.
What does Part A cover?
- Inpatient care in hospitals
- Inpatient care in skilled nursing facilities
- Home health care
- Hospice care
Inpatient care is the care you get when you are admitted to places such as a hospital or skilled nursing facility. Service covered with inpatient care in hospitals and other facilities includes room expenses, food, the cost of nursing care, medications needed while at the facility, as well as a range of other necessary services and other medical supplies.
Skilled nursing facilities are nursing facilities that provide more than just custodial care. If you need assistance with daily living such as bathing or getting dressed, Part A won’t automatically qualify you for care in a nursing facility. However, if you need services such as physical therapy or rehabilitation, Medicare will cover all your needs in a skilled nursing facility. And that does include help with daily living needs.
Home health care is a variety of health care services provided within the home. It can include but is not limited to skilled nursing care in the home, physical as well as speech therapy, and even necessary medical equipment such as wheelchairs, walkers, oxygen systems, and specialized beds.
Hospice care is specialized care for those that are terminally ill and is covered under Medicare Part A. This kind of care can include in-home care, therapy services, as well as counseling for grief and loss.
Medicare Part B
Medicare Part B is also known as medical insurance. It covers medical services related to doctor care. Part B covers care and treatments that are medically necessary. The monthly premiums for Medicare Part B are at an average of $144.60 each month with average of $185 for the deductible.
What does Part B cover?
- ambulatory services
- durable medical equipment
- mental health and preventative services
- clinical trials
- other services and supplies that are medically necessary
Ambulatory services are any properly equipped transportation service by land, air, or water vehicles to a medical facility. The vehicle has to be properly equipped and staffed specifically for medical emergencies. This includes vehicles such as ambulances and life flights by helicopter.
Durable medical equipment includes any sort of equipment for use in the home that is deemed necessary by a doctor or other qualified medical professional. Be sure to note that nursing facilities do not usually qualify as a ‘home’. Durable medical equipment covered under part B can include movement items such as wheelchairs, canes, walkers, and other equipment that aid in mobility. It can also include specialized beds, oxygen, lifts, and a variety of other equipment you may need.
Mental health services are specialized services and can include care from psychiatrists and other mental health specialists. Preventative services are services of routine health care. This can include services such as screenings and checkups that are meant to be preventative of various health problems.
Clinical trials are final stages of the research process and are well thought out testing of cutting edge medical care. It can be testing variation in treatment to see what methods work better. Or it can be using existing treatments in a new way to treat other health conditions. This helps doctors and researchers and paves the way for new methods to be more broadly used.
Medically necessary services and supplies are not just things you or your doctor find convenient for your situation. These supplies and services must meet certain qualifications for your area. Services and supplies such as these are usually directly needed for diagnosing or treating your specific medical conditions.
Medicare Part C
Medicare Part C is offered by private insurance companies and includes the benefits of Part A and Part B. It can also sometimes include the benefits of Part D depending on the plan. Part C is also known as Medicare Advantage. It can also offer additional benefits such as dental and vision coverage. The average monthly premiums for Part C are around $28 but can vary from $0-200.
What does Part C cover?
- Part A with hospital insurance
- Part B with medical insurance
- Part D with prescription drug insurance
- dental care
- vision care
- hearing care and hearing aids
- other health and wellness activities and programs
Medicare Part D
Medicare Part D is insurance for prescription drugs. Not all plans cover all prescriptions. Check with various plans to see exactly what prescription are and aren’t covered and be sure to choose the plan that best meets your needs. The cost for Medicare Part D can vary but the average is a $34 premium per month. The deductible can also vary but the average is $308.
What does Part D cover?
- prescription drugs
Do you still need help with figuring out the right kind of coverage to get? Jim is here to help with YOUR individual needs! All of our services here at Signature Senior Solutions in Arizona are offered at no cost or obligation to you. Contact us today to set up an appointment to learn about your options.