Why is it necessary to understand the ABDs of Medicare?

Why is it necessary to understand the ABDs of Medicare?

Though the government programs help you reduce your healthcare and prescribed medicine costs. Let us understand the A, B, and D of Medicare in detail.

Medicare is health insurance for people of and over the age of 65 and for those under the age of 65 but with certain disabilities. There are different parts of Medicare- part A, part B, and Part D.

Part A- It covers the inpatient hospital cost. It is also known as hospital insurance. It includes hospital stays, nursing care, home health care, and hospice care. But it has an amount of 1408$ deductible per policy period and up to 704$ coinsurance per day for hospital stays for more than 90 days.

 

Part B- It covers outpatient medical services like doctor visits, diagnostic tests, and preventive care. It requires you to pay a few out-of-pocket expenses including a 198$ monthly premium, which is deductible annually and is usually 20% of total care cost.

Part D- It covers the cost of prescription drugs. It reduces medical costs by covering the costs of medicines. It does not cover over-the-counter drugs. A prescription by an authorized doctor is a must. The Part D premium differs from consumer to consumer. High-income consumers generally pay more.

Medicare Advantage- It is a comprehensive plan and includes the benefits of both, Part A and Part B. It also covers prescription drugs, medical and hospital costs. It is often called Part C or “MA Plans”. It is provided by Medicare-approved private insurance companies. They must abide by the rules made by Medicare. If one enrolls for Medicare Advantage, still one continues to be under Medicare.

Medicare Supplement (Medigap)Medicare Supplement includes the costs involved in health-related services and medical supplies. Not only this but also it covers the costs which are not covered by Medicare like- Co-pay and deductibles.

Apart from the above mentioned you can choose from tailored made plans as per your need with additional coverage. You can choose from the below options:

Out-of-Pocket expense coverage- Out of Pocket costs are those health care costs that you have to bear yourself as Medicare or other health insurance does not cover them. This option pays the additional amount that you pay like extended hospital stays, which are generally not covered by insurance.

Dental Insurance- It covers dental procedures, when required and dental screenings for preventive care. There is no enrollment period and you can opt-in any time of the year.

Vision Insurance- It is advisable to get your vision screening done at least once a year to diagnose any problems in the early stage. It can help you detect problems like cataract and non-vision problems like Diabetes. Under this also, there is no specific enrollment period.

People who are of 65 years and above are at higher risk of having serious health issues, hence there are various tests which are covered under Medicare that includes:

  •         Bone Density Screening
  •         Abdominal aortic screening
  •         Cardiovascular Disease screening
  •         Cervical and Vaginal cancer screening
  •         Colorectal Cancer screening
  •         Diabetes screening
  •         Hepatitis B Virus infection screening
  •         Lung cancer screening
  •         Mammography
  •         Obesity Screening
  •         Prostate Cancer Screening
  •         STDs screening

There are various vaccinations given under this policy which includes:

  •         Pneumococcal shots
  •         Flu shots
  •         Hepatitis B Shots

There is an SNP- Special Need Plan for the disabled. It is somewhat like the Medicare Advantage plan but limits enrollment to people having certain disabilities. Medicare SNPs have tailored their services as per the needs like provider choices and drug formularies to meet the specific needs of the population they cater to. All SNPs cover prescription drug costs.

Medicare Cards:  Everyone who is covered under Medicare receives a Red, White, and a Blue Medicare card. This card has your name and your date of enrollment on it. It also displays your Medicare number that serves as a unique number and helps in identification in the Medicare system. Always remember to carry your Medicare Card while visiting a Doctor or a hospital, so that they can submit your bills to Medicare for payment.

 If you have a Medigap Policy, then they use this card to submit bills for your out-of-pocket expenses. If you are enrolled under part D of Medicare then, this card will help you at the pharmacy. If you are enrolled under the Medicare Advantage plan, then you must carry your Medicare Advantage card which will cover all expenses under part D of Medicare.

One can log in to MyMedicare.gov to manage his or her health as it contains all benefits, premium, deductible, and all necessary information one can look for. One should understand all the various options under and apart from Medicare before enrollment under Medicare.

 Always keep in mind that there can be different Medicare plans in different areas, and you must choose a plan suitable for your area. You can call on 1-800-MEDICARE to find out a suitable plan in your area.

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