The 4 parts of Medicare plans explained

Health

The 4 parts of Medicare plans explained

Health

Medicare health plans are provided by private companies and are beneficial to individuals who enroll in them. They offer several financial benefits for healthcare services and cover a wide range of conditions. Medicare has four parts: hospital insurance, medical insurance, an alternative way to receive Medicare benefits, and prescription medication coverage.

Let’s understand these in detail.

Part A – Hospital insurance
Medicare Part A covers hospital or inpatient expenses, including the cost of hospital stays, skilled nursing care, hospice care, and limited home healthcare services. Individuals usually pay a deductible or can opt for copayments. Part A premium usually depends on the number of years an individual has worked for.

Part B – Medical insurance
Medicare plans under this type cover the costs of a range of healthcare services, including:

  • Visits to the doctor
  • Tests, screenings, and other preventive services
  • Vaccinations
  • Pneumococcal shots
  • Outpatient mental healthcare
  • Counseling
  • Physical therapy and chemotherapy
  • Medical supplies and equipment like wheelchairs
  • Outpatient Diabetes Self-Management Training (DSMT)

Part B coverage can also extend to the expenses for other healthcare services depending on an individual’s medical necessities. Everyone is required to pay a monthly premium for Medicare Part B.

Part C – Medicare Advantage
Private companies approved by Medicare offer Medicare Part C or Advantage plans. These plans provide coverage for both Parts A and B, along with additional coverage like hearing, dental, vision, and health and wellness programs. Most Medicare Advantage plans also include Part D coverage for prescription medications.

Part D – Prescription medications
Medicare Part D provides coverage for prescription medications, along with recommended vaccines. Part D coverage is offered to everyone with Medicare, but it is optional. Individuals need to join a Medicare-approved plan that offers coverage for generic and brand-name medications, but each plan varies in cost and the medications covered. The actual cost of medication coverage depends on an individual’s prescriptions and the tier their medication is listed under, among other factors.

Typically, individuals opt for Original Medicare, the traditional fee-for-service program, to receive their Part A and Part B benefits. Under this, an individual’s healthcare costs are directly paid by the government.