THE FOUR PARTS OF MEDICARE

Michael T Braden August 27, 2024 THE FOUR PARTS OF MEDICARE

The Four Parts Of Medicare

BACKGROUND OF MEDICARE IN AMERICA

Medicare is the National Healthcare plan for everyone in America age 65 and over. Medicare is part of the United States Department of Health and Human Services. Everyone enrolls in Medicare through the Social Security Administration. Once they are approved and enrolled in a Medicare Plan their Healthcare is managed by Medicare. There are some disabled Americans who may be granted Medicare before age 65.

Medicare was first envisioned by President Harry S, Truman however, it never became law until 1968, when President Lyndon B. Johnson signed it into Law. Harry and Bess Truman were the first two Medicare Beneficiaries in the United States. Today, Medicare has 4 Parts (A, B, C & D)

Medicare is the largest Health Program in the United States.  It serves over 64 million Americans, and for all of the Medicare jokes you may have heard, Medicare really is FANTASTIC healthcare, and you get to customize how you want your Medicare to work for you. 

Original Medicare has always been made up of Two Parts, Medicare Part A and Medicare Part B, ever since Lyndon Johnson signed it into law.  Then, under Bill Clinton, Medicare added the 3rd part of Medicare, Medicare Part C.  Medicare Part C was originally referred to as Medicare Choice at the time, but later became known as Medicare Advantage.   And lastly, George W. Bush added the last part of Medicare to date, Medicare Part D. Medicare Part D covers Prescription Drug plans.

We are going to jump in and give some what I hope is simple and, information about the Four Parts of Medicare. 

THE FOUR PARTS OF MEDICARE AND WHAT MEDICARE PART A COVERS

MEDICARE PART A

Covers Hospitalization Costs, Skilled Nursing Care and Hospice Care. Medicare Part A is basically free to 99% of those enrolled in Medicare. This is what we pay for during our working careers in Medicare and Social Security taxes.

 

WHAT IS COVERED UNDER MEDICARE PART A

MEDICARE PART B

Cocentervers Outpatient Services, surgical centers, doctor visits, Lab Work, Diagnostics, doctor visits, Durable Medical Equipment (DME), and Treatments received as an Outpatient in a Hospital or Doctor's Office. Some Prescriptions are also included under Part B, but; only those that must be administered by a physician, RN or NP. Medicare Part B costs EVERYONE $170.10 per month in 2022. This does not matter what type of plan you choose; everyone is charged this amount and there are many who have to pay a higher amount for Part B if they are considered "High Wage Earners".

 

THE FOUR PARTS OF MEDICARE & WHAT MEDICARE PART B COVERS

What is covered Under Medicare Part B

THE FOUR PARTS OF MEDICARE & WHAT MEDICARE PART C COVERS

MEDICARE PART C

Originally named Medicare Choice (That Is Where Part C Came From). This Is what is known as Medicare Advantage Plans. Instead of your Medicare being a Government Health Plan, Medicare Advantage plans are offered by private insurers.

Medicare Advantage Plans were designed to give Medicare Beneficiaries an alternative to Original Medicare. Medicare Part C plans and Medicare Part C plans are the same thing. While these plans are required to cover the same things as Original Medicare, they cover them in different ways, and ultimately, the decisions made are made by the Insurance company,

Medicare Advantage plans offer a variety of "Extra" or "Additional" benefits not offered by Medicare. These are items such as: Dental, Vision, and Hearing benefits, Transportation to medical appointments, OTC Subsidy, Credit Back toward your Part B Premiums, and help with groceries and utilities. How can they do this? The Government pays the Medicare Advantage Insurance companies 12K annually for each Medicare Beneficiary they have enrolled in one of their plans. This is also where the money comes from for all of their Advertising/Commercials.

Medicare Part C plans all have a MOOP. MOOP stands for Maximum-Annual-Out-Of-Pocket amount. So if the plan you like has a $5,000 MOOP, it simply means that you would need to pay $5,000 out of your pocket in the form of Co-Pays and Co-Insurance before your plan will pay 100% of your Healthcare Costs. Because every Medicare Advantage (MA) plans are based on a Calendar Year, the MOOP re-sets on January 1st each year.

THE FOUR PARTS OF MEDICARE & WHAT MEDICARE PART D COVERS

MEDICARE PART D

Covers Prescription Drugs and Prescription Medications. Typically, you choose the best, lowest priced Prescription Drug Plan (PDP), it includes a premium and the costs of your medications. You can change these plans every year if your medications change during the previous year.