ABCs of MEDICARE
Turning 65? Getting ready to retire? If so there are critical decisions you will have to make about your health coverage. Failing to do so with in certain timelines could result in both penalties and gaps in coverage. Click read more to see an overview of the different parts of Medicare that we can help you with.
MEDICARE PART A
Days 1-60 $1364 deductible
Days 61-90 $341 per day
Days 91 and to 150 (60 lifetime reserve days) $682 per day
Skilled Nursing Facility
(must be in the hospital as an inpatient 3 or more days)
Days 1-20 $0 per day
Days 21-100 $170.50 per day
Days 101 and beyond you pay all costs
MEDICARE PART B
Part B Deductible $185 yearly
After your deductible is met, you generally pay 20% of the Medicare approved amount for most doctor services, outpatient therapy and durable medical equipment. You will also pay for most doctor services while you are a hospital inpatient.
In 2019 the standard Part B premium is $135.50 per month.
MEDICARE PART C
MEDICARE ADVANTAGE PLANS
Medicare Advantage Plans are offered by private insurance companies approved by Medicare. If you join a Medicare Advantage Plan you are still part of the Medicare program. However your Part A and Part B benefits are provided by the Medicare Advantage Plan rather than Original Medicare.
These plans are required to cover all services approved by Medicare. Most Medicare Advantage Plans offer services in addition to Original Medicare and may also include Part D prescription drug coverage. Most Advantage Plans will be HMO’s or PPO’s.
MEDICARE PART D
Medicare Part D plans are prescription drug plans offered by private insurance companies approved by Medicare. Each plan has its own list of covered drugs called a formulary. Within the formulary there are different drug tiers. The cost of your drug will depend on the tier it falls under. Typically the lower the tier the lower the cost.
Medicare Part D has a standard deductible of $415 in 2019. Some plans offer a lower deductible while others have no deductible at all. Part D Plans may also have discounts when using certain preferred pharmacies or mail order services. You can enroll in Part D coverage by purchasing a stand alone Prescription Drug Plan or by enrolling in one of the various Medicare Part C options (Advantage Plans) available in your service area.