Medicare Part A – Your Hospital Insurance. It is free for everyone who is eligible for Medicare.
Medicare Part B – Your Medical Insurance (doctor, preventive and outpatient services).
There is a monthly premium for Part B. For 2022, the standard premium is $171.10. Your Part B premium may be higher based upon your taxable income. Your premium is either withheld from your monthly social security payment or paid by you directly to Medicare.
Medicare Part D – Your Prescription Drug Coverage.
It is available to everyone on Medicare, but you will pay a separate monthly premium for this coverage directly to the insurance company providing the coverage. Your premium is withheld from your monthly social security check or paid by you directly to the insurance company.
As With All Insurance, You Pay Annual Deductibles & Copayments
Medicare Part C or Medicare Advantage Plans are health insurance policies offered by private insurance companies and approved by Medicare.
Medicare pays insurance companies to combine Part A (hospitalization), Part B (providers), and Part D prescription drug coverage into one policy. These Plans offer additional benefits not offered or covered by Medicare. All Plans have a maximum out-of-pocket medical cost.
Medicare Advantage Plans must follow the rules set by Medicare. However, each Plan can charge different out-of-pocket costs and have different rules for how you get services (such as whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the Plan).
The most common Plans offered by carriers are HMO and PPO policies. Both HMO and PPO policies have a network of providers.
You must choose a primary care physician (PCP) associated with a specific medical group with an HMO policy. All referrals to a specialist such as a cardiologist or a neurologist will be within the assigned medical group. You cannot go to any specialist outside the medical group.
With a PPO policy, you may also go to any provider in the insurance carrier’s County, Regional, or Nationwide PPO network. In addition, you may go to any provider that accepts Medicare, but you may pay a higher amount for your medical services.
To be eligible to enroll in a Plan, you must be enrolled in Medicare Part A and B, reside in the Plan’s service area (zip code or county), and continue to pay your Part B premium.
Private insurance carriers sell Medigap Plans. There are eight standardized Medigap Plans designated by a letter (A through N). Medigap policies only work with Medicare. They do not cover Medicare benefits but work in tandem or coordinate with Medicare.
These Plans will pay some or all the Part A deductible, co-insurance, and copayments and fill all or part of the 20% Part B gap. A Medigap policy cannot be sold to someone already in a Medicare Advantage Plan.
If you turned 65 after January 2020, the optimum or top Medigap policy is Plan G. Plan G pays all Part A medical expenses and the 20% gap of Part B expenses (after payment of the Part B $233 deductible).
These videos are for educational purposes. We represent many of the top carriers available. We will review your unique situation and be able to offer you a variety of carrier products and plans to choose from.