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Medicare Part A, B, C and D. What Does it All Mean For You & Where Do I Go To Get Started?

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Health insurance is anything but simple, but it can be easier to understand if each aspect is explained. As an eligible American, you might be wondering what is Medicare and how can it help me? Medicare is a program that millions of Americans are enrolled in as it covers individuals with certain disabilities and those over 65.

Medicare started in 1965 when it was signed into law to help elderly individuals have quality healthcare and was expanded after its initial introduction. Break down the program into its four sections of part A, B, C and D to get a better understanding of how they all work together to form comprehensive health insurance.

Original or Traditional Plans

Medicare part A and Medicare part B is also commonly known as original or traditional Medicare. Part A is responsible for paying hospital premiums if you end up sick and need care while in a hospital. Services covered under this include inpatient hospitalization, nursing facilities, and hospice care. The premium for this is paid through taxes you paid while you were in the workforce. And by those currently paying into the system. You may be responsible for deductibles, copayments or coinsurance with Medicare Part A even though a premium isn’t required in order to be enrolled.

Medicare part B works with part a by providing coverage for other necessary outpatient services. These include visits to your primary care physician, specialists, therapies, dialysis, vaccines and certain drugs including immunosuppressive therapy and cancer treatment. It includes a premium in addition to copayments, coinsurance or deductibles. There is a penalty imposed if you do not enroll in part b coverage at the same time as part A to discourage late enrollment based on an urgent need for services. This is a ten percent total increase for every 12 months that you were eligible for it and opted not to purchase it.

Medicare Advantage Plans

Medicare part c is more commonly referred to as a Medicare Advantage plan. These plans are offered by private insurance companies but have been approved by Medicare to operate. Individuals who wish to enroll in Medicare part C must already be enrolled in both parts A and B before purchasing an additional plan. These plans frequently combine prescription drug coverage, available through Medicare part D, along with parts A and B into a single plan. These plans also cover more services such as vision or health and wellness services. You’ll be responsible for paying a premium. And your overall costs may be lower than with a traditional plan depending on your overall medical needs.

Medicare Part D

Medicare part D is the portion responsible for paying for prescription drugs, something many individuals depend on daily. Especially the aging population and disabled. It is sold through private companies, sometimes in conjunction with part C, and is an optional program that has a penalty imposed if you don’t enroll in it when you do for the program as a whole. You are responsible for paying 51 percent of the plan’s costs once you surpass the coverage limit, but this is reduced to a significantly lower coinsurance or copayment when the out-of-pocket drug costs reach a catastrophic phase of around $5,000. The costs of the medications are controlled based on tiers in many circumstances and it can save money to opt for generics instead of name-brand pharmaceuticals.

Getting Started with the Program

If you’re on social security you are automatically enrolled in the program. But if not you should apply three months before your 65th birthday. You have four months after you turn 65 to sign up for the program. There are certain financial subsidies available to certain groups of individuals based on income to make it a more affordable option. 

Wondering what is Medicare and how it is going to work for you can be scary as you step into new territory. But don’t worry, it is an easy journey when the terminology is familiar. To get your Medicare started so you can begin to utilize its advantages simply go to the official government Medicare site and sign up for benefits. The process takes less than ten minutes and you’ll be all set. You can also seek out the Centers for Medicare and Medicaid Services or CMS.  In case you need assistance with getting enrolled in the program that meets your needs.