THE BASICS OF MEDICARE

MEDICARE PART A 

Pays for hospital stays, skilled nursing care, blood, and hospice. About 99% of people enrolled in Medicare Part A never will have to pay a premium for Medicare Part A coverage because of the Medicare Taxes they paid through payroll deductions throughout their working careers. The Medicare Deductible for Medicare Part A is $1,632.

MEDICARE PART B 

Covers outpatient services such as preventative care, doctor visits, lab work, diagnostic imaging, outpatient surgery, durable medical equipment, chemotherapy, radiation treatments, Drug Injections for various ailments, and more.

EVERYONE who enrolls in Medicare Part B must pay their monthly Medicare Part B Premium and their Annual Part B Deductible, regardless of whether they participate in Original Medicare, a Medicare Advantage Plan, or even if they choose Original Medicare with a Medicare Supplement policy. Your Medicare Part B premium can be Paid by Credit Card, Direct Bill, EFT Transfers, or can be paid from your monthly Social Security Benefits.

For 2024 the monthly Medicare Part B premium is $174.70, and the Annual Part B Deductible will be $240. This means you must meet the annual Deductible before Medicare begins to pay.

Both Medicare Part A and Medicare Part B are 80% paid for by the government and 20% is the responsibility of the beneficiary or the patient. With Original Medicare you are free to choose and Doctor or Hospital that accepts Medicare Terms for payment. (Approximately 94% of all Doctors accept Medicare.

MEDICARE PART C 

Medicare Part C is most commonly referred to as Medicare Advantage or MA. Medicare Advantage plans are still 80/20 plans but instead of the government, these plans are offered and managed by private insurance companies. where the private insurance company pays for 80% of covered services and you are responsible for the other 20%. You must pay your 20% share whenever you receive medical services. You are also responsible to pay for any/all co-pays and deductibles.  

M/A plans are either HMO (Health Maintenance Organization) or a PPO network (Preferred Provider Organization). With these plans you must use the Doctors and Hospitals listed in their network in order to receive full coverage for any procedure.  

The company decides which services they will pay for and honestly, they are well known for denying claims and coverage, they just do not disclose that in their TV commercials or Marketing flyers/Postcards/Brochures.

Medicare Advantage plans each have their own MOOP.  MOOP stands for Maximum-Out-Of-Pocket Expense. This is the amount you must pay for before your insurance company pays for all of your healthcare services.  

MEDICARE PART D 

Covers Prescription Drugs. Because there is no prescription drug coverage with Original Medicare (except for those drugs and medications that are provided during a hospital stay).  

On October 8, 2003, President George W. Bush signed Medicare Prescription Drug coverage into law.

Medicare Part D  covers retail prescription drugs for Medicare beneficiaries through unique, stand-alone drug insurance plans. 

You pay a monthly premium to join any Medicare Part D Prescription Drug plan available in your area that fits your needs the best. Choose the Plan that saves you the most money on your prescription medications.   These plans range from $0.00 - $169 per month. We strongly believe that it is best to work with an experienced Medicare Broker like BradenMedicare.com to find the best plan at the lowest cost for your individual needs.

Each Insurance Company offering Medicare Part D Prescription Drug Plans must have at least 1 Plan that offers the Senior Savings Model which caps the monthly maximum you can spend on Insulin at $35.00. 

You should review your plan annually and you can change your plan in the fall, during the medicare Annual Enrollment Period (AEP),individual and the new plan will begin on January 1st every year.