The Medicare program continues to be vital to retirees age 65 and older, younger people with certain disabilities, and people suffering from amyotrophic lateral sclerosis, commonly known as ALS or Lou Gehrig’s disease.
In January, 2020, Seema Verma, CMS Administrator, touted Medicare’s accomplishments in 2019, noting a reduction of cumbersome regulations and paperwork, expansion of transparency in pricing, procedures covered as an outpatient previously covered only for inpatients, and Medicare Advantage benefit enhancements.
Medicare Part A
Part A is the hospital insurance component of Original Medicare. In addition to inpatient care in a hospital, skilled nursing facility and religious nonmedical health care setting, Part A also covers hospice and home health care.
According to the Centers for Medicare & Medicaid Services, about 99% of Medicare recipients pay nothing for Part A based on their employment history. The premium for Part A is free for those with a minimum of 40 quarters of Medicare-covered employment. Those who do not meet the criteria have an option for voluntary enrollment with a premium based on the number of qualified quarters worked. For those with less than 30 quarters, the monthly premium is $458. If your work history falls in the range of 30 to 39 quarters, the monthly premium is $252. The Part A annual deductible is $1,408.
Medicare Part B
Part B is medical insurance, which covers outpatient services, doctor visits, home health services, durable medical equipment and mental health services. For Part B, the standard monthly premium is $144.60. The Part B annual deductible is $198.
The standard monthly premium amount applies to beneficiaries who file individual tax returns with an income reflected that is less than or equal to $87,000. Beneficiaries who pay a standard premium and file joint tax returns show an income less than or equal to $174,000. To see the full table of income-related monthly adjustment amounts (IRMAA) based on income level and tax filing, visit cms.gov.
Prescription drug coverage (Part D)
Prescription drug coverage is not part of Original Medicare (Parts A and B), but coverage can be purchased through a private Medicare-approved insurance company. Another option is to enroll in Medicare Advantage, known as Part C, which encompasses parts A and B, and often Part D. When shopping for drug plans, check to ensure that your current medications are covered. Often the drugs will be listed in tiers that signify the level of coverage.
Medicare Advantage (Part C)
MA plans are popular because they often include prescription drug coverage, and some are premium-free. Additionally, in 2020, there is more emphasis on additional benefits, such as transportation to the doctor’s office, over-the-counter drugs, adult day care and wellness programs.
Whether or not you enroll in Part C, the first step is to apply for Parts A and B. The Original Medicare premium is paid directly to Medicare. If the MA plan you choose charges a premium, you would be responsible for paying that to the insurance company.
Medicare Supplement plan options
Medicare enrollment in Medicare Supplement plans, otherwise known as Medigap, is attractive to beneficiaries who are interested in Original Medicare but want to add insurance to fill coverage gaps. Some Medigap plans offer out-of-pocket limits and cover foreign travel emergency care. The two Medigap plans that cover the Part B deductible for current plan participants are Plans C and F, but they will no longer be offered for those coming into Medicare enrollment for the first time in 2020.