Medicare
Medicare is the public health insurance program for Americans aged 65 and older, as well as some younger individuals with disabilities or end-stage renal disease, and those with permanent kidney failure who meet specific conditions.
Medicare has four parts:
Part A covers inpatient hospital stays, skilled nursing facility care, home health care, hospice care, and some outpatient services. Part B includes coverage for doctor’s office visits, outpatient care such as surgery and lab tests, physical therapy, and other skilled nursing care.
Part C, also known as Medicare Advantage (MAPD or MA only) plans, is offered by private insurance companies approved by Medicare. These plans provide all the benefits of Parts A and B and may include additional benefits like prescription drug coverage and vision or dental care. MA-only plans do not include Part D and are ideal for those with VA or Tricare coverage.
Part D offers prescription drug coverage to Medicare beneficiaries, including those with limited income and resources. Each part of Medicare provides different types of coverage to meet a range of health care needs.
What plan is right for me?
Medicare Supplement Insurance, also known as Medigap, helps cover health care costs that traditional Medicare doesn’t fully pay for, such as deductibles and coinsurance.
Part D plans cover prescription medications and usually pair with a Medicare Supplement plan. If you don’t enroll in a Part D plan when eligible and don’t have alternative coverage like VA, Tricare, or creditable employer coverage, you will face a Part D penalty.
The Part D penalty is an additional cost you pay for not enrolling in a Medicare Part D plan when eligible. This late enrollment penalty is calculated as 1% of the national average premium for all Part D plans for each month you delay enrolling in a qualifying prescription drug plan.
If you are still working and covered by an employer-sponsored health plan, you can avoid the penalty by staying in your current plan. However, if you are no longer employed and lack other health coverage options, it is crucial to sign up for a Medicare Part D plan as soon as possible.
Medicare Advantage (Part C) is a type of Medicare coverage that combines health insurance with traditional Medicare benefits (Parts A, B, and D) and adds extra services. Offered by private companies approved by Medicare, Medicare Advantage plans provide all the benefits of Original Medicare (Parts A and B) and may include additional benefits not covered by Original Medicare, such as dental or vision coverage. These plans also offer flexibility to see any doctor or hospital that accepts Medicare within their network.
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