Medicare Plans

Medicare is important for people 65 years or older. There are four parts to the Medicare benefits.

MEDICARE PART A – Hospital Coverage

Part A provides coverage for inpatient hospital care, inpatient stays in nursing facilities and hospice services. Relying solely on Medicare Part A is risky since it doesn’t give you complete health care coverage. Because of this, you should also enroll in Medicare Part B to cover regular visits and other needs outside of in-patient care.

Eligibility

• You are eligible for Part A if you or your spouse paid into Social Security for at least 10 years through your employment and if you are a citizen or permanent resident of the U.S.

Part A Costs

• Most individuals do not pay a monthly premium for Part A because they or their spouse paid Medicare taxes while working.
• If you aren’t eligible for premium-free Part A, you may be able to buy Part A if you meet certain conditions. call Social Security at 1-800-772-1213 TTY hearing impaired is 1-800-325-0778) between 7:00am and 7:00pm on business days, to see if you qualify and to check the amount you will pay for your Part A premium. If you have limited income and resources, your state may be able to help you pay for your Part A and/or Part B premium.
• Part A can have a substantial deductible, co-payment and co-insurance.

MEDICARE PART B – Medical Coverage

Part B medical coverage has a monthly premium for most beneficiaries and provides benefits and coverage for doctor services, preventative care, home health care, surgical fees, physical therapy and most of your regular health needs. You are eligible for Medicare when you reach the age of 65, but it is also available for anyone under the age of 65 with a disability or anyone who has ALS (Amyotrophic Lateral Sclerosis).

Eligibility

• Anyone who is eligible for Part A can enroll in Medicare medical insurance (Part B) by paying a monthly premium.

Part B Costs

• Part B requires a monthly premium which most people have deducted directly from their monthly Social Security check. Most people will pay the standard premium amount. Social Security will contact you if you have to pay more based on your income. If you don’t sign up for PArt B when your first eligible, you may have to pay a late enrollment penalty.
• There is a Part B annual deductible amount and other costs (such as co-payments and co-insurance) may apply.

MEDICARE PART C – Medicare Advantage Coverage

Part C is a government subsidized and combines both Medicare Parts A and B along with Part D. This means if you enroll in a Part C, you will receive hospital insurance, medical insurance and prescription drug coverage in one plan. In addition to receiving all your medical benefits, the Part C plan may include coverage for vision, hearing, dental and other wellness programs.

Eligibility

• If you have Medicare Parts A and B, you can join a Medicare Advantage Plan.

Part C Costs

• In addition to paying your monthly Medicare Part B premium, you might have to pay a monthly premium for your Medicare Advantage Plan because of the extra benefits it offers. There might also be some cost-sharing.

MEDICARE PART D – Prescription Drug Coverage

Prescription drug can be combined with Part C, a Medicare Advantage Plan or it can be offered as a stand-alone Part D plan. Part D plans help cover the cost of your needed prescription drugs and can help lower your cost and protect you against higher costs for your medications throughout the year.

Eligibility

• Anyone who has Medicare hospital insurance (Part A), medical insurance (Part B) or a Medicare Advantage Plan (Part C) is eligible for prescription drug coverage (Part D)

Part D Costs

• Most drug plans charge a monthly fee that varies by plan. you pay this in addition to the Part B premium. If you belong to a Medicare Advantage plan (like an HMO or PPO) that includes Medicare prescription drug coverage, the monthly premium you pay to your plan may include an amount for prescription drug coverage.
• A small percentage of Medicare beneficiaries with higher incomes will pay a higher monthly Part D premium. If you must pay a higher premium, the Social Security office will send you a letter with your premium and the reason.
• There could be a yearly deductible amount and other costs (such as co-payments or co-insurance per prescription). Some Medicare drug plans have different levels or “tiers” of co-insurance or co-payments, with different costs for different types of drugs.

The SilverCare team is here to answer ALL your questions. Let us help you take the Mystery out of Medicare! 

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