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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 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.
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, at-home care, or skilled nursing facility care. Medicare Part A also provides coverage for wheelchairs or walkers, blood transfusions, surgery, and lab tests.

What it Covers
  • Hospital care (inpatient)
  • Limited home health services
  • Care in a skilled nursing facility (SNF), 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, is sold privately. It includes all the coverage of Medicare Parts A and B, with additional coverage for dental care (including X-Rays), vision care, and hearing care, plus some fitness benefits (such as coverage for gym memberships). Medicare Part C can be tailored to suit individual healthcare needs of chronically ill enrollees.

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 Plan

Many individuals will choose to enroll in a Medigap plan for coverage that extends to medical supplies and services not covered by Medicare Parts A, B, C, or D. Medigap, which private insurance companies sell, is also lettered. Ten different types of plans are available: A, B, C, D, F, G, K, L, M, and N. A Medigap plan supplements your original Medicare benefits and covers things like copayments, deductibles, and health care costs when you travel outside the United States. Individuals who enroll in Medigap plans will have to pay a premium on top of the cost of their original Medicare benefits.

What You Need to Know About Medicare Supplement Insurance

If you're enrolled in Medicare, you may be considering purchasing a Medigap 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 generally the same, regardless of insurance provider. The significant difference will be in cost, which varies by 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 Medicare is not a fully comprehensive insurance policy, many individuals with advanced medical and healthcare needs may not be covered by it.
Because Medicare is not a fully comprehensive insurance policy, many individuals with advanced medical and healthcare needs may not be covered by it. Original Medicare (Parts A and B), when combined with the prescription coverage of Plan D, may pay most of your medical expenses. Still, if you become seriously ill or injured, your out-of-pocket medical expenses may be extremely high without Medigap or supplement insurance protection.
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 licensed insurance providers.
Medigap policies are guaranteed renewable, even if you have serious health problems, which means that as long as you pay your premium, your insurance company can't cancel your Medigap plan.
Original Medicare (Parts A and B), when combined with the prescription coverage of Plan D, may pay most of your medical expenses. Still, if you become seriously ill or injured, your out-of-pocket medical expenses may be extremely high without Medigap or supplement insurance protection.
What is Medicare Advantage?
Medicare Advantage is meant to be an all-in-one insurance plan that covers health care costs and expenses that are not covered by Medicare Part A and B. Usually, Medicare Advantage includes all the benefits of Part A, B, and D (prescription drug coverage) in addition to coverage for services like transportation to doctor visits, over-the-counter drugs, and services that promote your health and wellness such as gym memberships.
Medicare Advantage also offers coverage for dental care (including X-Rays), vision, and hearing care.
Original Medicare (Parts A and B), when combined with the prescription coverage of Plan D, may pay most of your medical expenses. Still, if you become seriously ill or injured, your out-of-pocket medical expenses may be extremely high without Medigap or supplement insurance protection.
How do I get a Medicare Supplement 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 plans, such as Medicare Advantage or a Medigap policy, from a private insurance company.

Medicare Insurance Carriers

Insurance carriers may include:

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How Much Does Medicare Insurance Cost?

The cost of your Medicare plan will depend on which parts you enroll in, whether you purchase any supplement insurance or Medigap, and the private insurance provider from whom you purchase any supplement coverage.

Part A and Part B Medicare costs are federally regulated.
Part A

Most people don't pay a monthly premium for Part A. However, if you purchase Part A, your monthly premium can cost up to $499 per month in 2022. If you have been paying Medicare taxes for fewer than 30 quarters, the premium is $499, and if you paid Medicare taxes for 30-39 quarters, the monthly premium is $274. (source)

Part B

For Part B, the standard monthly premium in 2022 is $170.10 but may be higher depending on your income, and the deductible and coinsurance cost is $233. 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/Medicare Advantage costs vary depending on your plan and insurance provider.

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 $170.10 for 2022, an increase of $21.60 from $148.50 in 2021. The annual deductible for all Medicare Part B beneficiaries is $233 in 2022, an increase of $30 from the annual deductible of $203 in 2021."

Is Medicare Part A free at age 65?

If you sign up for Part A, you may pay up to $499 each month in 2022; 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 government 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 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. Many Americans have supplemental coverage, like Medigap or Medicare Advantage.

How do I enroll in Medicare?

You can enroll for original Medicare, which means Parts A and B, through medicare.gov. All other types of coverage, including supplement plans, Medigap, and Medicare Advantage, can be purchased through private insurance companies.

What are the Best Medicare Advantage Plan Providers?

The best Medicare Advantage plan provider for you will depend on your health and insurance needs.

For anyone already enrolled in a Medicare Advantage plan, you have the opportunity to switch plans during the forthcoming 2023 Medicare Advantage Open Enrollment Period.

Contact Coverage Haven today to find a suitable plan for your health needs and budget.

Can I drop my employer health insurance and go on Medicare?

It is likely advisable to remain on your employer’s health insurance plan until your employment ends, at which time you may enroll in Medicare.

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

Does Medicare have deductibles?

Yes, there are deductibles for Medicare. Learn more here on what was deductible in 2022 and what we can maybe expect in 2023.

*note these figures are continually updated as soon as data and information are available.

Is it mandatory to go on Medicare when you turn 65?

It is not mandatory to enroll in Medicare when you turn 65. If you are still actively working for an employer who provides health insurance when you turn 65, you are entitled to a special enrollment period of eight months after your employment ends.

What is an AARP Medicare Supplement Plan?

AARP Medicare Supplement Plans pay for some of the out-of-pocket costs that are not covered by Original Medicare (Part A and Part B). This plan is generally only offered by private insurers such as UnitedHealthcare.

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-authorize 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.

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