Ashford Insurance

Plano Medicare Insurance

Ashford Insurance

Plano Medicare Insurance

Medicare in Four Parts

Medicare comes in four parts: A, B, C, and D. Here are a quick rundown of each part, so you know your options when you’re ready to enroll (or change your coverage):

  • Medicare Part A is hospital coverage. It covers inpatient hospital care and skilled nursing facility care. Most people don’t pay a monthly premium for this coverage, but it does include deductibles and coinsurance when you receive care.
  • Medicare Part B covers medically necessary care, such as flu shots, doctor’s visits, outpatient surgery, insulin, and other types of services. Everyone pays a premium for Part B, along with a 20% coinsurance rate for medical services.
  • Medicare Part C is also known as Medicare Advantage. This is the private portion of Medicare, sold by private companies but regulated by the federal government. By law, Advantage plans cover everything that Original does (Parts A and B together). Beyond that, these plans have flexibility in benefits, typically covering extras that Original doesn’t, like prescription drugs, dental and vision benefits, hearing aids, and more. Premiums and cost-sharing vary.
  • Medicare Part D covers prescription drugs. This is also a private portion of Medicare, sold by individual companies. It’s only available to people with Original Medicare. Costs vary with this portion as well.

Are You Eligible for Medicare?

Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States.

If you are not 65, you might also qualify for coverage if you have a disability or with End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).

Here are some simple guidelines. You can get Part A at age 65 without having to pay premiums if:

  • You already get retirement benefits from Social Security or the Railroad Retirement Board.
  • You are eligible to get Social Security or Railroad benefits but have not yet filed for them.
  • You or your spouse had Medicare-covered government employment.

If you are under 65, you can get Part A without having to pay premiums if:

  • You have received Social Security or Railroad Retirement
  • Board disability benefit for 24 months. You are a kidney dialysis or kidney transplant patient.

While you don’t have to pay a premium for Part A if you meet one of those conditions, you must pay for Part B if you want it. It is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you don’t get any of the above payments, Medicare sends you a bill for your Part B premium every 3 months.