Senior woman with little boy at the lake

Medicare Part A

Part A covers you when you’re admitted to an inpatient facility. This will give you coverage for costs such as the room you stay in, the meals provided for you, and the medical treatments you get in the inpatient setting.

Your coverage starts after you’ve met your deductible, which is $1,484 in 2021. Deductibles are based on benefit periods which start when you’re admitted as an inpatient. These are not technically annual costs. After this, you pay nothing else for the first 60 days. If you happen to stay longer than 60 days, you pay $371 in coinsurance every day. If your stay lasts more than 90 days, you pay $742 daily. You have to cover all hospital costs after 150 days.

The premium can be free if you’ve worked at least 40 tax quarters and you join during your Initial Enrollment Period, which starts three months prior to your 65th birthday and ends three months after that. Otherwise, premiums can be anywhere between $259 to $471 per month.

Part B

Part B covers outpatient services, as long as they’re deemed medically necessary. Your Part B plan will cover preventive care, immunizations, durable medical equipment, and ambulance services.

Its annual deductible is $203, with monthly premiums being $148.50. If your plan covers your outpatient treatment, it will pay 80% of the coinsurance costs.

Part C

Also known as Medicare Advantage. Even though this plan has all of Medicare Part A, B, and D’s benefits, you still need to be enrolled in Medicare Part A and Part B to get it, and you will still need to pay those premiums and other related costs.

This covers everything Original Medicare does, with bonus benefits such as dental care and vision treatments.

Different versions of this exist. Types of Medicare Advantage include:

• Health Maintenance Organization (HMO)

• Preferred Provider Organization (PPO)

• Private Fee-for-Service (PFFS)

• Special Needs Plans (SNPs)

• Medicare Savings Account (MSA)

The coverage takes place within a network, not just any US healthcare facility. Some plans, like PPOs, allow out-of-network coverage for a higher price while others don’t.

Part D

Part D is Medicare’s prescription drug plan. This plan is offered through private insurance and has the most cost and coverage variables.

Coverage is based on formularies, which are lists consisting of the medications your plan covers. While formularies are different between plans, there are protected classes that every plan must offer coverage for (e.g. anti-cancer and HIV/AIDS medications).

While there are no universal premium or deductible costs, it can be said that the standard monthly Part D premium is $33.06, and that annual deductibles cannot be any higher than $445.

For All Your Medicare Needs

Cashmore Financial Group is the number one source for all Medicare-related needs. If you are considering enrolling in any of these plans, or have questions about them, don’t hesitate to email us at randy@cashmorefinancial.com or call us today.

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