Some people get Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance)automatically and other people have to sign up for it. In most cases, it depends on whether you’re getting Social Security benefits.
How much does Part A cost
How do I get Part A and Part B
How do I get Part A and Part B
You usually don't pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes for a certain amount of time while working. This is sometimes called "premium-free Part A."
Most people get premium-free Part A.
What does Part A cover
How do I get Part A and Part B
What does Part A cover
In general, Part A covers:
Hospital care
Skilled nursing care
Nursing home care (as long as custodial care isn't the only care you need)
Hospice
Home health services
What Part B covers
Does Original Medicare cover Prescription Drugs
What does Part A cover
Part B covers two types of services:
Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
How much does Part B cost
Does Original Medicare cover Prescription Drugs
Does Original Medicare cover Prescription Drugs
Most people will pay the standard premium amount. If your modified adjusted gross income is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago. This is the most recent tax return information provided to Social Security by the IRS.
The standard Part B premium amount in 2022 will be $233 (or higher depending on your income).
Does Original Medicare cover Prescription Drugs
Does Original Medicare cover Prescription Drugs
Does Original Medicare cover Prescription Drugs
With a few exceptions, most prescriptions aren't covered in Original Medicare. To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.
Original Medicare has a Part A deductible of $1,556 per benefit period. A benefit period is the way Original Medicare program measures your use of inpatient hospital and skilled nursing facility (SNF) services. It begins the day that you enter a hospital or SNF and ends when you have not received inpatient hospital or Medicare-covered skilled care in a SNF for 60 days in a row. Part B has a yearly deductible (2022) of $233 and typically 20% coinsurance after the deductible is met. There is no maximum out of pocket on your medical expenses. This is what makes our OPTIONS TO ORIGINAL MEDICARE so attractive in the next section.
Options to original Medicare
Medicare Advantage Plans
Suppliment Plans / Medigap
Suppliment Plans / Medigap
Also called Medicare Part C
They are Medicare-approved private health insurance plans for individuals enrolled in Original Medicare, Part A and Part B. When you join a Medicare Advantage plan, you are still in the Medicare program and must continue paying your Part B premium.
Medicare Advantage plans provide all of your Medicare Part A (ho
Also called Medicare Part C
They are Medicare-approved private health insurance plans for individuals enrolled in Original Medicare, Part A and Part B. When you join a Medicare Advantage plan, you are still in the Medicare program and must continue paying your Part B premium.
Medicare Advantage plans provide all of your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage. These plans often have networks, which mean you may have to see certain doctors and go to certain hospitals in the plan’s network to get care.
Medicare Advantage plans may potentially save you money because out-of-pocket costs in these plans can be lower than with Original Medicare, Part A and Part B, in some cases. Pricing will vary by plan provider, so it’s worthwhile to review all plans in your area. Your costs will vary by the services you use and the type of plan you purchase. Each Medicare Advantage plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or can use only doctors, facilities, or suppliers in the network).
Suppliment Plans / Medigap
Suppliment Plans / Medigap
Suppliment Plans / Medigap
A Medicare Supplement Insurance / Medigap policy helps pay some of the health care costs that Original Medicare doesn't cover, like:
Copayments
Coinsurance
Deductibles
Medicare Supplement policies are sold by private companies.
Some Supplement policies also cover services that Original Medicare doesn't cover, like medical care when you travel
A Medicare Supplement Insurance / Medigap policy helps pay some of the health care costs that Original Medicare doesn't cover, like:
Copayments
Coinsurance
Deductibles
Medicare Supplement policies are sold by private companies.
Some Supplement policies also cover services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Supplement policy, here's what happens:
Medicare will pay its share of the Medicare-approved amount for covered health care costs.
Then, your Medigap policy pays its share.
A Medicare Supplement policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a supplement policy only supplements your Original Medicare benefits.
Prescription Drug Plans
Suppliment Plans / Medigap
Prescription Drug Plans
Also Called Part D.
Individuals on Medicare are eligible for prescription drug coverage under a Part D plan if they are signed up for benefits under Medicare Part A and/or Part B. Beneficiaries obtain the Part D drug benefit through two types of plans administered by private insurance companies: the beneficiaries can join a standalone Pres
Also Called Part D.
Individuals on Medicare are eligible for prescription drug coverage under a Part D plan if they are signed up for benefits under Medicare Part A and/or Part B. Beneficiaries obtain the Part D drug benefit through two types of plans administered by private insurance companies: the beneficiaries can join a standalone Prescription Drug Plan (PDP) for drug coverage only or they can join a public Part C health plan that jointly covers all hospital and medical services covered by Medicare Part A and Part B at a minimum, and typically covers additional healthcare costs not covered by Medicare Parts A and B including prescription drug (NOTE: Medicare beneficiaries need to be signed up for both Parts A and B to select Part C whereas they need only A or B to select Part D.)
Craig Kempinski
I am an Arizona licensed insurance broker as well as a full time Phoenix Firefighter. I am married and have 3 young children. Being a firefighter, I have helped many sick and injured people and see the importance of having proper medical insurance that fits your particular needs. That’s why I became an insurance broker that specifical
I am an Arizona licensed insurance broker as well as a full time Phoenix Firefighter. I am married and have 3 young children. Being a firefighter, I have helped many sick and injured people and see the importance of having proper medical insurance that fits your particular needs. That’s why I became an insurance broker that specifically deals with Medicare only products. I am a broker with many of Arizona’s largest companies and can find the product that best suits your needs.
(602) 960-1765
Medicare Advantage, Medicare Supplement Insurance or Prescription Drug Plans.
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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area which are plans offered by a number of MA organizations. Please contact Medicare.gov,
1–800–MEDICARE, or your local State Health Insurance Program to get information on all of your options.