Medicare and Medicare Insurance - A Beginner's Guide to Understanding the Parts of Medicare

Medicare and Medicare Insurance - A Beginner's Guide to Understanding the Parts of Medicare

Turning 65 or going on Medicare for the first time can be an overwhelming experience in one's life. Coupled with that, most make an attempt, sometimes futile, to understand the complex world of Medicare and Medicare insurance. This article is to serve as a primer of the "parts" of Medicare, of which there are currently four, and what they do.

Part A

Part A is the part of Medicare plans in Philadelphia that everyone gets from paying into the social security system during their working life (as long as they meet the minimum work amount requirements). The primary thing that it covers as inpatient hospital care, and you will sometimes here it referred to as the "hospital" part of Medicare. However, it does also cover skilled nursing facility care, home health care and hospice facility care.

Part B

Medicare Part B is optional - most people who have employer coverage that works with Medicare coverage do not necessarily need Part B until or unless their employer coverage ends. Medicare Part B has a monthly premium associated with it, that is typically paid out of one's social security check.

Part B covers "services" primarily, and it is sometimes called the "doctor's office" part of Medicare. Some of the primary things that it covers include doctor's services, diagnostic tests, outpatient services and physical therapy and some preventive-type screenings.

Part C

Part C is the portion of Medicare that was created in the last 10 years. It is sometimes referred to as "privatized Medicare", but is primarily known as Medicare Advantage. In Part C, a private insurer that has a contract with the government takes over management of all of your Medicare benefits. Your benefits are all provided through this private insurer - you pay premiums directly to this company and they pay claims on your behalf.

This is an optional part of Medicare. You still have to pay the Part B premium and you do not altogether "lose" Part A and Part B, but Part C does provide your benefits in place of A & B. Also, you can not have (or do not need) a Medicare Supplement plan and Part C - most elect to either have one or the other. Supplements pay AFTER Medicare pays; Medicare Advantage pays INSTEAD of Medicare.

Part D

Part D is the part of Medicare that you may hear about the most. This is the portion of the Philadelphia Medicare Advantage program that covers prescription drugs. It is offered through private companies, which must be certified and approved by the Centers for Medicare & Medicaid Services on an annual basis to offer this prescription coverage (Part D).

You pay premiums directly to the private companies, although most offer the ability to deduct it automatically from your Social Security check. This is an optional part of Medicare - not everyone signs up for it when they are first eligible or at all.