Four Major Parts Of The Medicare Plan

We'll break down of the 4 major parts of Medicare coverage.

Meredith Miller
Published on
December 6, 2023
Updated on
March 4, 2024

As the Baby-Boomer generation continues to reach the age of retirement, along with entering their senior years in increasing numbers, so do their health needs rise in kind. In response to this, the United States Federal Government created Medicare to meet these challenges.

For the uninitiated, Medicare is a health care program run by the United States Federal Government for permanent US citizens. It is separate from Medicaid and Social Security programs altogether. Eligible are primarily those of age 65 and older with some younger individuals that may qualify if suffering a disability or an end-stage illness.

There are 4 important components within the Medicare Parts of the program. Understanding how these work can help one save both time and money when applying. It is always good to seek advice and guidance when choosing the right part that most suits a beneficiary before the application process to ensure they are on the right path in the long run.

No matter what, all beneficiaries get minimum payment assistance with Parts A, B, and D. C is simply an extra option for those that are interested. The following is the break down of the 4 parts in some further detail:

Medicare Part A

Medicare Part A assists in covering incidents where a patient is staying at a hospital, or even a skilled nursing facility. It can even help cover home health service and-or hospice care. Medicare Part A is ideal for those with immediate and urgent medical aid primarily. If the patient has paid up to 10 years or more in Social Security, they normally do not have to pay a premium. However, they must still pay the deductibles, co-payments, and co-insurance per the link here that provides a 60-second video with more detail with both Part A and Part B.

Medicare Part B

Medicare Part B aids in routine activities with a doctor or primary care physician regarding visits and exams, along with outpatient care, medical equipment, and some preventive procedures. However, it does not cover dental, vision or hearing. Medicare Part B also carries a monthly premium with deductibles, copay, and coinsurance. Eligible persons can seek guidance through various networks that cover HMOs and PPOs here as well when determining the right options.

Medicare Part C

Medicare Part C of the Medicare Parts consists of plans that are Medicare approved but covered by private insurers. These fall under optional programs with Medicare Advantage or Medigap plan that Medicare patients can pay for separately if they decide to do so. Medicare Part C incurs additional costs and is primarily for those that have the resources to elect it. If they do so, this means they can manage their health service like they once did before they were eligible for Medicare altogether. Details on Part C can be seen here. This is when the private payer is compensated by both the patient and the federal government.

Medicare Part D

Medicare Part D of the Medicare Parts covers the drugs themselves. Any beneficiary that qualifies for Parts A and B within Medicare automatically qualifies for Medicare Part D. This may be the last, but most certainly not the least part of Medicare as careful choices must be made as to what exactly is the healthiest option for medication in regards to the patient themselves.

It is not required to enroll in Part D but there could be serious consequences such as permanent late penalties and delayed coverage among other items. A good reference to check out regarding the details of Part D can be found at the AARP link.

The most important aspects of Part D is that there are always options within the program to assist at any time. Even if a patient's income is limited for example, there is a program called "Extra Help" they can look into for financial assistance. With "Extra Help", a patient need not pay more than 5 percent of the cost of each prescription after they have spent a certain amount during the course of a year.

Contact A Medicare Specialist

It is important not to dismiss the assistance and resources provided if at all possible without at least garnishing some information. This can be done by either accessing the website or calling 1-800-MEDICARE (1-800-633-4227), TTY: 1-877-486-2048 to be directed to a local Medicare Ombudsman or even a local Medicare office for that matter, if one decides to set up an appointment.

Like any other new endeavor, it appears that the best way to go about it is by utilizing resources on hand, and it would seem that Medicare overall has plenty available for everyone that is eligible.

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