Medicare benefits get broken down into four main categories when it comes to healthcare benefits for people aged 65 and older. Understanding the difference between Part A, Part B, Part B, Part C, and Part D can be challenging. Each part covers different types of care, and you’ll have options to choose from when you qualify for Medicare. We’ll break down some of the basics below and help provide some information about what Medicare pays for.
Part A
Medicare Part A will cover inpatient costs for a hospital stay when you a doctor orders you to be formally admitted for care. It gives you benefits for services like:
- Hospice care
- Wheelchairs and walkers
- Blood transfusions
- Some home health services
There is limited coverage for skilled nursing facilities if you also have a qualifying inpatient hospital stay. The stay has to be three consecutive days from a doctor’s orders for formal inpatient admission to qualify.
Part A Costs
Most people won’t have to pay a monthly premium for Medicare Part A benefits. If you choose to purchase Part A, you’ll pay up to $499 a month for in during 2022. If you paid Medicare taxes for at least 30 quarters, the standard premium is $499. If you paid these taxes for 30 to 39 quarters, the premium drops to $274. For the Part A hospital inpatient coinsurance and deductible, you’ll pay:
- $1,556 deductible for every benefit period
- Days 1 to 60: $0 coinsurance for every benefit period
- Days 61 to 90: $389 coinsurance per day for every benefit period
- Days 91 and Up: $778 coinsurance for each lifetime reserve day for every benefit period with a 60 day over the lifetime cap
- After Lifetime Reserve Days: All associated costs
Part B
Part B is responsible for paying for preventative healthcare and doctor’s services, including yearly visits and tests. People typically combine Part A and Part B to get both inpatient and outpatient healthcare coverage. For example, if you get formally admitted to a hospital on doctor’s orders, Part A would help pay, while Part B would cover doctor’s services in an outpatient setting. Part B helps cover many medically necessary services and supplies, such as:
- Diabetes, depression, and cancer screenings
- Hepatitis and influenza vaccinations
- Emergency department and ambulance services
- Diabetes supplies
- Durable Medical Equipment
- Visits to a doctor or specialist
Part B Costs
The standard premium for Part B is $170.10, but this can go higher or lower based on your income levels. The deductible is $233 for 2022. After you meet the deductible, you’ll pay 20% of the Medicare-approved costs.
Part C
Better known as Medicare Advantage plans, Part C is privately sold insurance benefits that offer the same coverage you’d get under Original Medicare with extra benefits added in like dental, prescription drug coverage, vision, and hearing. You have to enroll in Original Medicare before you can switch to a Medicare Advantage plan.
Part C Costs
There is sometimes a premium attached to these plans, and you may have to visit in-network doctors. Copayments and coinsurance may apply, too. The type of plan you pick will determine the cost as they all vary.
Part D
This is the plan that will cover prescription drugs that Part A and B do not. While Part B may help cover certain medications that a doctor needs to administer (such as injections or infusions), Part D coverage will help pay for medications prescribed by your doctor to take at home. This is an optional plan, but many people choose to make it part of their Medicare benefits unless they have other creditable drug coverage through an employer or group insurance plan.
Part D Costs
The cost will vary depending on which medication types you take, which pharmacy you use, and the plan you pick out. You’ll likely have a monthly premium, which may be based on your income. You could have to pay a deductible or make copayments.
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