When you turn 65, you become eligible for your senior healthcare benefits through the federally managed Medicare program. If you have been collecting Social Security disability benefits for at least two years, you would also qualify for Medicare. You may be taken back when you realize just how many parts and plans you need to familiarize yourself with to ensure you’re covered in every medical event.
Medicare Part A and B work together, but they provide different forms of coverage. Before getting started with your search, it’s a good idea to break down the differences and similarities of Medicare Part A vs B.
Medicare Part A Vs B
Medicare Part A is a referred to as hospital insurance, while Medicare Part B is typically called medical insurance. In many cases, they work together, however, they don't always overlap. Each covers something different, and there is also a significant difference in costs between the two plans.
Medicare Part A Basics
Medicare Part A covers hospital expenses, but coverage goes further than a traditional hospital stay. It also covers hospice admissions and home healthcare services. In many cases, it will cover skilled nursing care. As long as you require medical assistance rather than just custodial care, your Medicare Part A would cover your stay.
In most scenarios, if you don't have a secondary insurance you would be required to meet deductibles, pay coinsurance and a copayment. This is because your hospital insurance does not actually cover 100% of the cost of a hospital stay.
Medicare Part B Basics
Medicare Part B is your health insurance coverage. Part B covers two types of services, any medically necessary service that you need to treat an illness, or medical condition would be covered. For example, your visits to the doctor, any lab work, diagnostic imaging tests, preventative services, and outpatient surgeries would all be covered under Part B.
Part B also covers any durable medical equipment that you may need. This includes things like wheelchairs, walkers, crutches, canes, etc. Like Part A, Part B does not cover 100% of the amount billed. Part B covers 80%; therefore, the additional 20% would be your responsibility. Many people who have Medicare also carry Supplemental Plans to pick up the 20%.
How Do Medicare Part A and Part B Work Together?
Although Medicare Part A and Part B cover different services, they do work together. If you have been hospitalized after an injury, your Part A insurance would cover the cost for you to stay in the hospital. This includes a semi-private room, meals, and skilled nursing care. However, if you need any medical equipment, surgery, and lab work, your Part B insurance would pay.
Your medical insurance also pays your doctors while you are in the hospital. Even though they see you while you are in the hospital, these visits wouldn't be covered by Part A. If you are moved to a skilled nursing facility after the accident for physical therapy, Part A will cover your room, meals, and skilled nursing in the facility and your Part B coverage would pay the cost of your physical therapy.
How Much Do They Cost?
Medicare part A vs B costs differ depending on a variety of factors. For example, the majority of people will not need to pay a monthly premium for Part A, which is why it is often referred to as premium-free Medicare. If you don't qualify for a no premium Part, the cost of the Part would depend on how many quarters you paid Medicare taxes.
If you paid these taxes for 30 to 39 quarters, your premium would be $232 each month. If you paid Medicare taxes for less than 30 quarter, that amount would increase to $422 per month. Medicare Part B is different. This coverage would be based on your income. If you file an individual tax return, Medicare will look at what you made to determine the cost of your premiums. The table below is a guideline to the cost of your premium:
- If you made less than $85,000, you would pay $134 per month.
- If you made between $85,000 and $107,000, you would pay $187.50 per month.
- If you made between $107,001 and $133,500, you would pay $267.90 per month.
- If you made between $133,501 and $160,000, you would pay $348.30 per month.
- If you made $160,001 or more, you would pay $428.60 per month.
There are some people who receive Social Security benefits which can pay less than $134. To determine the true Medicare Part A and B Cost, you would need to contact your local Medicare office.
Why Do You Need Both
You need to have both Medicare Part A and Medicare Part B because they work hand-in-hand. For example, if you have Medicare Part B only and you are hospitalized, you would receive a bill for your room, your meals, and your skilled nursing care.
If you are hospitalized, and you have only Medicare Part A, you would receive a bill for most of the treatments and services that you received. Depending on the reason you were hospitalized, this bill can end up being hundreds of thousands of dollars. To get the most coverage possible during a hospital stay, you will need both Medicare Part A and Part B.
