4 things to know about Medicare:
- Medicare is a federal health insurance program.
- Medicare covers senior citizens and people with disabilities.
- Medicare comes in 4 parts: Parts A, B, C, and D.
- Medicare Parts A & B are funded by the government. Parts C & D are provided by private health insurance companies.
Medicare is a federal program that ensures citizens who are disabled or 65 and older have affordable health care options. Over 37 million people were enrolled in Medicare Part A and/or Part B in 2015, according to 2016 data from the Centers for Medicare and Medicaid Services (CMS).1
There are four parts of Medicare: Part A, Part B, Part C, and Part D. Each part covers different services. Medicare Part A and Part B are provided by the federal government and Part C and Part D are provided by private insurance companies.
Medicare terminology can get a little confusing. The different parts are also often referred to in the following ways:
- Parts A & B combined: Original Medicare
- Part C: Medicare Advantage
- Part D: Prescription Drug Coverage
What does Medicare cover?
Each part of Medicare provides different health care benefits:
- Part A provides uniform hospital insurance benefits.
- Part B provides uniform medical insurance benefits.
- Part C provides the same benefits as Parts A & B, plus additional benefits depending on which plan you buy.
- Part D covers prescription drugs. Actual benefits vary depending on which plan you buy.
Medicare Part A hospital insurance
Part A offers hospital insurance benefits and is the first half of Original Medicare. It covers inpatient hospital stays, hospice care, and skilled nursing facility care.
In 2019, the deductible for Medicare Part A hospital care is $1,364 per benefit period. A benefit period starts on the first day that you are admitted for inpatient care at a hospital or skilled nursing facility. The benefit period ends when you haven’t received inpatient care for 60 consecutive days.
There is no limit to the number of benefit periods you may have, and the Part A hospital care deductible must be met again for each benefit period.
Medicare Part B medical insurance
Part B offers medical insurance benefits and is the second half of Original Medicare. It covers outpatient hospital care, preventative care, doctors services, and other services. You must have Part B to qualify for Medicare add-ons such as Medicare Supplement Insurance (Medigap) and Medicare Advantage.
The standard Medicare Part B premium in 2019 is $135.50 per month, but premiums can vary based on your income. The annual Medicare Part B deductible in 2019 is $185 per year.
Medicare Part C (Medicare Advantage)
Part C is insurance that covers the same things as Original Medicare, but it is provided by private companies and usually includes additional benefits, such as prescription drug coverage, vision, dental, and wellness programs.
Medicare Part D prescription drug coverage
Part D is the Prescription Drug Coverage portion of Medicare. The plans are offered by private insurers and not the federal government. It is an optional add-on. The prescription drugs covered and the costs of Part D plans will vary based on the insurance provider.
Medicare eligibility and enrollment
In order to qualify for Medicare coverage, you must be at least 65 years old and a citizen (or permanent legal resident) of the United States. You also may qualify if you are under 65 and have a disability.
Most seniors will be enrolled in Original Medicare automatically. If not, applicants can apply during certain enrollment periods.