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What Does Medicare Cover in General?

Medicare is a federally-funded health insurance program that covers eligible individuals 65 years or older, as well as those under 65 who have specific disabilities or end-stage renal disease. Medicare generally covers hospitalization, doctor visits, preventive services, and some prescription drugs.

Individuals may enroll in Medicare Part A & B through the federal government's website or by contacting their local Social Security office. Generally, individuals who are already receiving Social Security benefits will be automatically enrolled in Medicare Parts A and B. However, those not receiving Social Security benefits must enroll in Medicare actively. Parts C and D also require active enrollment with a private health plan.
Medicare Part A

Medicare Part A covers hospital inpatient costs if you are admitted to a hospital by a doctor, in addition to hospice care, some at-home care, and some skilled nursing facility care.

What it Covers
  • Hospital care (inpatient)
  • Limited home health services
  • Temporary care in a skilled nursing facility (SNF) after an inpatient hospital stay,provided that custodial care not be the only care required
  • Hospice care
Medicare Part B

Medicare Part B covers preventive healthcare, such as yearly doctor visits and tests, cancer screenings, some vaccinations, diabetes supplies, and ambulance and emergency room services.

What it Covers
  • Visits to a healthcare facility
  • Ambulance services
  • Part-time or temporary home health care
  • Rehabilitation services and physical therapy
  • Cardiovascular, cancer, and diabetes screenings
  • Mental health services
  • Clinical research
  • Durable medical equipment
  • Limited outpatient prescription drugs
  • Flu and hepatitis b shots
Medicare Part C

Medicare Part C, also known as Medicare Advantage plans, are offered by Medicare-approved private companies that must follow rules set by Medicare. It includes all the coverage of Medicare Parts A and B, and some plans may include additional coverage for services such as dental care (including X-Rays), vision care, and hearing care, plus some fitness benefits (such as coverage for gym memberships).

Medicare Part D

Medicare Part D covers prescription drugs not covered by Part B, which covers medication that needs to be administered by a doctor (such as injections).

Medigap Policy

Medigap is Medicare Supplement Insurance that helps fill gaps in Original Medicare. Original Medicare pays for much of the cost for covered health care services and supplies, but not all of it. A Medigap policy can help pay some of the remaining costs, like copayments, coinsurance, and deductibles. Not all Medigap plans cover travel outside the U.S. at 100%.

What You Need to Know About Medicare Supplement Insurance

If you're enrolled in Medicare, you may be considering purchasing a Medigap (also called Medicare Supplement) policy to help cover some "gaps" in Original Medicare coverage. Medigap is private health insurance that can help pay for out-of-pocket costs not covered by Medicare, such as copayments, coinsurance, and deductibles.

In most states, 10 government-standardized Medigap plan types are available, which differ in coverage, premiums, and cost-sharing features. When deciding whether to purchase a Medigap policy, you must consider your health care needs and budget to determine which type of policy makes the most sense for you.

Comparison Of Medicare Supplement Plans

Many Medicare Supplement Plans are available, and it can be difficult to know which is right for you. Medicare supplement plans are regulated by state and federal laws, which means that the primary benefits offered by lettered supplementary plans (A, B, C, etc.) are the same, regardless of the insurance company. The significant difference will be in cost, which varies by insurance provider.

No matter which plan you choose, you'll need to pay a monthly premium in addition to your Medicare Part B premium. You may also be responsible for meeting an annual deductible before your coverage kicks in. But with any of these plans, you'll have the peace of mind of knowing that you're covered in the event of an unexpected hospital stay or other medical emergencies.
Who Should Buy Medicare Supplement Insurance?
Because Original Medicare is not a fully comprehensive insurance plan, many individuals with advanced medical and healthcare needs may desire additional coverage. If you become seriously ill or injured, your out-of-pocket medical expenses may be extremely high. Medicare Supplement Insurance (Medigap) plan may reduce any of those out of pocket costs.
How do I get a Medicare Supplement Insurance plan?
Medicare Supplement insurance plans can only be purchased if you already have Medicare coverage (Parts A and B). If you do, you can purchase Medicare Supplement (Medigap) plans from private insurance companies.
Medicare Part A, B & Medigap
Medigap is a supplementary plan designed to cover healthcare costs not covered by Medicare. It can only be purchased by individuals already enrolled in Medicare Part A and B. If you choose to enroll in a Medigap policy, you will pay a private insurance company a monthly premium, in addition to the premium you pay for your Part B Medicare plan. A Medigap policy only covers one person and can only be purchased from private insurance companies.
What is Medicare Advantage?
Medicare Advantage is meant to be an all-in-one insurance plan. Medicare Advantage plans must include all the benefits of Parts A & B, and many plans also include Part D (prescription drug coverage). Some Medicare Advantage plans may offer additional benefits such as transportation to doctor visits, allowances for over-the-counter drugs, and services that promote your health and wellness such as gym memberships. Some Medicare Advantage plans may offer coverage for dental care (including X-Rays), vision, and hearing care.

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How Much Does Medicare Insurance Cost?

The cost of Medicare insurance varies depending on the plan that is selected. Typically, the monthly premium for Medicare Part A (hospital insurance) is $0 for people who have worked and paid Medicare taxes for at least 10 years. However, the premiums for Part B (medical insurance) and Part D (prescription drug coverage) can be more expensive, depending on the plan that is chosen.
Part A

Most people don't pay a monthly premium for Part A. However, if you don't qualify for Part A, your monthly premium can cost up from $278 or $506 in 2023, depending on how long you or your spouse worked and paid into Medicare taxes. Your deductible for the year is $1,600 in 2023, before Original Medicare begins to pay. (source)

Part B

For Part B, the standard monthly premium in 2023 is $164.90 but may be higher depending on your income. The deductible and cost is $226. After this deductible is met, you typically pay 20% of the Medicare-approved amount for medical services. (source)

Part C & D

The Part C and Part D plans costs vary depending on your plan and insurance company.

Frequently Asked Questions
Medicare Insurance Quotes FAQs
How much is taken out of your Social Security for Medicare?

According to cms.gov, "The standard monthly premium for Medicare Part B enrollees will be $164.90 for 2023, a decrease of $5.20 from $170.10 in 2022. The annual deductible for all Medicare Part B beneficiaries is $226 in 2023, a decrease of $7 from the annual deductible of $233 in 2022."

Is Medicare Part A free at age 65?

If you sign up for Part A, you may pay up to $506 each month in 2023; however, most people qualify for premium-free Part A. To be eligible for premium-free Part A at age 65, you must meet the following criteria:

  • You or your spouse-maintained Medicare-covered job
  • Currently, you receive retirement benefits from the Railroad Retirement Board or Social Security.
  • You qualify for Railroad benefits or Social Security, but haven't yet applied.

If you are not age 65, you could qualify for premium-free Part A if:

  • You have an End-Stage Renal Disease (ESRD) diagnosis and meet specific requirements.
  • For 24 months, you have gotten Railroad Retirement Board or Social Security benefits.
  • In most situations, if someone decides to buy Part A, they also have to have Medicare Part B (Medical Insurance) and pay each monthly premium.
How much does Medicare cost each month?

The cost of your Medicare will depend on which plans you are enrolled in.
You generally pay a monthly premium for your Medicare coverage and a portion of the costs each time you get a covered service. With Original Medicare, there is no yearly limit on what you pay out-of-pocket. This is why many individuals have Medicare Advantage.

How do I enroll in Medicare?

You can enroll for Original Medicare (Part A and Part B) through Medicare.gov. Medicare Advantage plans, Part D plans, and Medigap plans must be purchased through private insurance companies.

How can I compare Medicare plans?

Medicare.gov’s Medicare Plan Finder is the best tool for you to search and compare Medigap Policies, Medicare Health Plans, and Prescription Drug Plans.

You may want to compare plans to ensure that you have a plan that meets your health needs. There could be varying reasons to want to review and even switch plans, such as; unsatisfaction with current coverage, increased costs, changes in prescription costs, or even if you reach a qualifying event such as moving to a new area.

When Is Open Enrollment Period For Medicare?

Medicare Fall Open Enrollment for 2023 is October 15th to December 7th, 2022.

Does Medicare have deductibles?

Yes, there are deductibles for Original Medicare. Learn more here on what we can maybe expect in 2023. In 2023, the Medicare Part A deductible is $1,600, an increase of $44 from 2022. In 2023, the Medicare Part B deductible is $226, a decrease of $7 from 2022.

Does Medicare Cover Telehealth? 

Telemedicine/Telehealth is covered by Medicare Part B and Part C.

Does Medicare cover COVID-19 Costs?

Medicare covers the following COVID-19 costs costs.

FDA-authorize and FDA-approved COVID-19 vaccines.
Lab tests for COVID-19.
COVID-19 Over-the-Counter tests. (8 per month)
FDA-authorized COVID-19 antibody tests.
Monoclonal antibody treatments for COVID-19.
All medically necessary hospitalizations regarding COVID-19.
Expanded telehealth services during the Public Health Emergency.
source

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