Understanding the ABC’s of Medicare

Understanding the ABC’s of Medicare

It’s been a long time since you mastered you’re ABC’s, but learning the ABC’s (and D too) of Medicare can make you feel like a frustrated school kid again.

Just like when you were young, repetition is key to learning and having the information sink in. You can’t just read about the different parts of Medicare once and expect yourself to remember each specific part. But many find Medicare extremely “boring” and don’t want to “deal with it”. If you’re that type of person I advise that you not to try to make sense of Medicare when the time comes without the help of a local professional. Or worse yet, do nothing at all by procrastinating. There are several costly mistakes that you can make, some that can affect you for the rest of your life.

Part A: Helps partially pay for inpatient hospitalization, skilled nursing facilities, home health services and hospice. Part A costs you nothing if you (or a spouse) paid Medicare payroll taxes for at least 40 quarters.

Part B: Helps partially pay for doctor’s services both in and out of the hospital and outpatient medical services such as physical therapy, diagnostic testing, chemotherapy, durable medical equipment and much more. You pay a premium for Part B. $121.80 is now the new standard premium for those making up to $85K a year that are single and up to $170K a year if they’re married. If you make more than that, you’ll pay more for Part B AND for your Part D coverage. If you have low income, you may qualify for help with your Part B premium and Part D drug costs.

Part C: Is offered by private insurance companies that the government goes into contract with. Part C gives you your Medicare benefits and more. It fills in a lot of the gaps of Original Medicare, and generally adds Part D coverage as well. You have to use networks to make Part C work favorably for you, and referrals are needed for the HMO plans. The upside to this is that there is a LOT of doctor and hospital participation here in Orange County and most Part C plans carry zero premiums. All you have to do is pay your Part B premium to the government.

Part D: Even if you don’t take prescriptions drugs, you must have a Part D plan in place or you’ll be subject to a late enrollment penalty. You can purchase a “stand alone” Part D plan or you can obtain it for zero cost if you enroll in a Part C plan that includes it. The most important thing about selecting your Part D plan is making sure you pick one that has all of your drugs covered at the lowest co-pays possible.

Stephanie Frisch

Stephanie Frisch is the owner of Insurance 101 and is an independent insurance broker dedicated to helping others make “educated decisions” about their insurance choices when it comes to Medicare, Long-Term Care Planning, The Health Insurance Marketplace-Covered California and Life Insurance. For answers to your questions, or an in-home, no-fee consultation, call (949) 351-2443.