Medicare Basics

Dave Ramstack
Dave Ramstack
Published on February 11, 2021

Medicare options for senior citizens

Medicare is a health insurance program provided by the United States federal government that is available for seniors or disabled persons. Medicare offers a variety of enrollment options that can be overwhelming or even confusing. Understanding all the options and how the coverage applies helps agents to customize the right Medicare coverage for each customer.

In addition to the coverage plans, you should also familiarize yourself with the pricing options. Seniors looking to retire are going to be concerned with a fixed budget. American Senior Benefits works with our customers to educate them on their Medicare options and help them find the right fit for them.

Medicare Part A and B

The government’s original Medicare comprises two parts – Medicare Part A and Medicare Part B. These coverages address basic medical needs. Medicare Part A is specific to hospital stays. While in the hospital, a patient would be covered for the hospital room, diagnostic care, procedures, and medication required for adequate medical treatment. This coverage also applies to skilled nursing home stays and treatment. However, this coverage is specific to hospitalizations.

For things like doctor’s visits, individuals need Medicare Part B. Medicare Part B provides coverage that is defined as medically necessary or preventative. This coverage applies to primary care or other outpatient medical treatment.

Medicare Part C and D

Medicare Part C is also known as Medicare Advantage. A Medicare Advantage Plan will offer combinations of Medicare Parts A and B. Some coverages that are not offered under Parts A or B may be available with some Medicare Advantage plans. This includes hearing aids, wellness plans, or dental plans. Some Medicare Advantage plans may also have prescription coverage. Otherwise, this is covered under Part D plans.

Medicare Advantage plans are provided by private health insurers and provide coverage in coordination with Medicare. Medicare Advantage plans offer increased flexibility and coverage but often still have copays, deductibles, or coinsurance costs.

Supplemental Medicare Coverage

There are some medical costs not covered by either original Medicare or Medicare Advantage Plans. For medical expenses not covered by Medicare, there are supplemental MediGap plans. MediGap plans differ from Medicare Advantage Plans in that they work in addition to other Medicare programs to address out-of-pocket medical expenses.

Cost

Medicare costs for Parts A and B are based on income. The prices are available on Medicare’s website, as are additional details regarding Medicare plan coverage. For those individuals who pay a Part A premium, the monthly cost is up to $471. Part B premiums are $148.50. The out-of-pocket expenses include a deductible for Part A coverage at $1484 and $203 for Part B coverage. Medicare Part B also only covers 80% of medical costs.

Individuals who make more than $88,000 per year or couples who make more than $176,000 per year can expect to pay higher premiums. The cost of the Medicare premiums and out-of-pocket expenses can be addressed through customized MediGap and Medicare Advantage Plans.

Medicare Advantage Plan costs will vary based on the health insurance provider, the state where the customer lives, and other benefits. Medicare Advantage Plans can be explored and matched to an individual’s needs.

Final Thoughts

Signing up for Medicare is a daunting task for many people due to the cost and multiple options. Medicare, Medicare Advantage, and MediGap plans can be mixed and matched to an individual’s needs.

To learn more about Medicare Plans, contact the experts at American Senior Benefits. Our licensed experts will be happy to answer any questions you have.

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