As of 2020, about 18% of the U.S. population was under Medicare protection. However, the program is still largely misunderstood, and most people are unsure what it covers and when to enroll.
To help you understand the program better, this post focuses on the different parts of Medicare plans and the health services covered. Read on to learn more.
Part A: Hospital Coverage
Upon applying for Medicare, you automatically have hospital coverage. This part covers surgeries, in-home hospice care, inpatient care in hospitals, home healthcare services, skilled nursing facilities, and inpatient care in religious non-medical healthcare institutions.
You aren't required to pay any premiums if you have been paying Medicare payroll taxes. However, you'll need to pay a deductible every time you are hospitalized. The deductible amount changes every year, but as for 2022, it will be $1,556. You can also purchase Medicare supplement insurance to cover the deductible and other costs in your policy.
Part B: Doctors and Tests
Medicare also covers doctor visits, medical equipment, diagnostic screenings, ambulance transportation, lab tests, purchase of blood, cardiac rehabilitation, and other outpatient services. You don't need to enroll for part B if you already have creditable coverage, for example, from your employer or your spouse's health plan. But, if you fail to enroll and don't have creditable coverage, you risk a fine if you decide to enroll later.
Generally, the monthly premium for part B is set by the federal government. For 2022, it will be $170.10, although you may be required to pay higher if your income is over $91,000. You'll also pay a deductible before part B pays for your services. The deductible is set at $233 for 2022.
Part C: Medicare Advantage
Medicare Advantage is a health insurance alternative to traditional Medicare coverage. It combines all the other parts of Medicare to form one plan and is administered by private insurance companies. However, you'll still need to enroll for part A and part B before applying for a Medicare Advantage plan.
Typically, part C Medicare covers everything that Original Medicare (part A & part B) covers. But it may include additional benefits like:
- Prescription drug coverage
- Dental, hearing, and vision services
- Fitness club memberships
Regarding costs, you'll need to pay part B premiums and an additional premium to the insurance company providing your part C plan. The premium amount often varies, depending on your Medicare Advantage plan.
Part D: Prescription Drugs
Like part C, Part D Medicare is offered by Medicare-approved private insurance companies. It mainly covers prescription drugs. Every part D Medicare prescription drug plan contains a list of the drugs it can cover, so it's advisable to check if the plan you are considering has the drugs you take.
Depending on your plan, you may be required to pay a monthly premium and a deductible. And if your income exceeds $87,000, you may incur an extra monthly charge, known as a Part D Income Related Monthly Adjustment Amount (IRMAA).
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