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Medicare Part A (along with Medicare Part B) make up what is commonly known as Original or Traditional Medicare. Part A specifically covers hospital care, skilled nursing facility care, hospice care and home health care. While Part B cover such things as doctor services, outpatient care, and preventive services.
The various “parts” can be what makes Medicare confusing at first, but that’s actually what makes Medicare rather smart if you think about it. It was created with these different parts so that you can build a coverage plan that fits your unique needs and lifestyle. No “one-size-fits-all” here, and that’s where Healthpilot cracked the code of being able to show your recommended plan in minutes and where you can also complete your enrollment online, fast, and securely – but more on that later.
Part A and Part B are foundational to your Medicare program. You have to be at least 65 years old (or younger if you have certain medical conditions) to qualify. If you don’t have private insurance, such as an employer, but want more coverage, you can add Medicare’s other parts to support the medical coverage you need.
Eligibility for Parts A and B (Original Medicare) are the same. You don’t have to have Part B to get Part A, so if you do choose to sign up for Medicare A without enrolling in Medicare Part B, know that the eligibility requirements do not change. Just be aware that if you choose to delay Part B coverage because you already have credible coverage, you have 8 months after that credible coverage ends to enroll in Part B before penalties kick in.
Knowing what each part of Medicare covers will ensure you not only get the best coverage for yourself while making a very informed choice, but also prevent any billing-related surprises in the future.
Hospital stays. Part A helps cover the tests and treatments you may need once you have been admitted to the hospital. This also includes services like nursing services, physical therapy, meals, and most medications that your doctor prescribes for your care.
Short-term skilled nursing facilities. Medicare Part A will help cover your inpatient stay and services in a skilled nursing facility for a certain amount of time if you need it.
Home healthcare. You will have help with coverage if it is deemed that you need medical care from a home health professional while you recover from an inpatient hospital stay.
Hospice care. When yourself and doctor have chosen to seek hospice care for a terminally ill condition, Medicare Part A will help cover most of your healthcare costs for comfort care (palliative care) instead of care to cure your terminal illness.
It is important to note that Medicare Part A will help cover an ER visit if it results in your being admitted to the hospital by a physician. However, if you return home without being admitted to the hospital, Medicare Part B or your private insurance may be able to help pay the costs, but not Medicare Part A.
As you approach your 65th birthday or if you just found out you are eligible for Medicare benefits, you may have Medicare plans on the brain. And who wants to be thinking about Medicare? Medicare plans can seem complex, but it can be easier than you think.
Part A and Part B are the two parts of Original Medicare. Medicare Part A usually doesn’t charge a premium (if you qualify for Premium Free Part A) and pays for hospital care, skilled nursing facility care, and hospice care. Part B of Medicare pays for medical care (like doctor visits) and preventive services as well as some medical equipment. There is usually a monthly premium for this coverage.
Medicare Supplement plans, a.k.a Medigap plans, provide State Department of Insurance approved-private insurance coverage. It helps by paying some of your health care costs that Original Medicare doesn’t cover like copayments, coinsurance and deductibles, hence bridging the “gaps” in Original Medicare. Clever, right? Keep reading for a quick guide to Medigap insurance.
Private insurance companies offer Medicare Supplement insurance to supplement Original Medicare coverage. Also known as Medigap, Medicare Supplement insurance helps you pay the portion of medical expenses you would traditionally have to pay out-of-pocket, like Medicare deductibles, coinsurance, and copayments. The monthly premiums that various insurance companies charge for the same coverage can vary considerably regarding Medigap policies. Compare the different Medigap plan types using the same letter when looking for a Medigap policy and consider the premiums each insurer charges. As an example, evaluate Plan G from two different companies. You can always turn to your State Health Insurance Assistance Program (SHIP) for guidance or make life a whole lot easier on yourself by letting Healthpilot analyze your unique situation to identify which Medigap policy could be the best fit for you.
The majority of states offer the same 10 standardized Medigap policies to their residents (except Massachusetts, Minnesota and Wisconsin, which use different standards). The plans vary from one another in terms of the services that are covered, coinsurances, the out-of-pocket maximums, and the monthly premiums.
Another important note is that all policies are meant for your individual coverage only, so if you and your spouse need a Medicare Supplement Plan, you will have to purchase plans separately.
Before you begin researching and comparing the different Medigap plan choices, the first thing to keep in mind is to not let yourself get confused by the Medicare Alphabet. Medigap policy letters have nothing to do with the primary Medicare plan you choose. Medigap plans are standardized and consistent in all but three states, though if you happen to be a resident of Massachusetts, Minnesota, and Wisconsin, you will have your own standard policies.
When considering which Medigap policy or combination of policies is best for you, a best practice is to consider the items that could end up costing the most in the long run without proper coverage, like deductibles and coinsurance for lab tests, doctor visits, and hospital stays.
Most plans cover 100% of Part B coinsurance except plans K and L, which cover only a percentage of your Part B coinsurance but limit how much you have to pay out of pocket. Once you’ve paid your Part B deductible and meet your out-of-pocket limit, the insurance carrier will pay of all of your covered services for the rest of the calendar year. Each year, these out-of-pocket maximums may go up because of inflation.
Remember, too, that Medigap does not cover prescription drugs, dental, vision, or most other needs that Original Medicare also doesn’t cover.
These nuances are what can leave people underinsured or confused when unexpected bills come rolling in. There is, of course, a better way.
Once you have Medicare Parts A and B, you are eligible for Medigap coverage.
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When you create an account on Medicare Pal, you receive a unique ID that you can use when talking to a licensed Medicare agent or accessing your account.
When you create an account on Medicare Pal, you get a unique ID that you can use when talking to agent or accessing your account.
Setting up you your profile is simple. Begin by selecting I do not have Medicare Pal ID, and then add your doctors and medications, or pick a preferred plan. Your medicare Pal ID will be created automatically.
