What Does Medicare Cover?

Medicare is an insurance program dispensed by the federal government for people who are 65 and above. It covers the healthcare insurance needs of people with permanent kidney failure. Components of Medicare include Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D, and Medicare Supplement Plans.

Each component handles aspects of a patient’s healthcare insurance needs and certain fees that they have to pay. The better you can traverse the intricate nature of America’s healthcare insurance, the more you can maximize its offerings.

Medicare Part A 

Part A is part of Original Medicare, which involves hospital coverage. Expenses that result from care received in a hospital, skilled nursing facility, or at home will typically be covered by Part A. For 2020, Part A’s deductible is $1,408.

Medicare Part B

Part B is the other part of Original Medicare that caters to medical coverage. It encompasses doctor visitations and healthcare services as an outpatient. Other coverages provided by Part B include:

• Screenings for depression, cancer, and diabetes
• Limited outpatient medications
• Clinical research 
• Ambulance transportation
• Mental health services
• Durable medical equipment

The government stipulates that the Part B monthly premium is $144.60 in 2020. The annual deductible is set at $198.

Medicare Part C

Medicare Part C, or Medicare Advantage Plans, is an alternative option to Original Medicare that also offers additional coverage, including prescription drug, dental, vision, and hearing coverage, among others. People who have Medicare Advantage must have enrolled in Parts A and B.

Because various private insurers offer Medicare Advantage Plans, their overall costs vary. However, some Advantage Plans have a $0 monthly premium.

Medicare Part D

Part D refers to prescription drug coverage, which includes medications not covered by Part B. Part D must cover: 

• Anticancer
• Antipsychotics
• Anticonvulsants
• Antidepressants
• Immunosuppressants
• HIV/AIDS drugs
• Common vaccines/immunizations

Part D coverage is divided into tiers. Typically, the lower the tier, the lower the cost of a prescription.

• Tier 1—Most generic prescription drugs with the lowest copayment
• Tier 2—Preferred, brand-name prescription drugs with a medium copayment
• Tier 3—Non-preferred, brand-name prescription drugs with a higher copayment
• Specialty tier—Very high-cost prescription drugs with the highest copayment

Part D premium rates and copays may vary significantly. You will also be responsible for paying copayments, deductibles, or coinsurance on drug costs.

Medicare Supplement Plans

Medicare Supplement Plans (Medigap) fill in the coverage gaps left behind by Original Medicare. They provide additional healthcare insurance needs and coverage through 10 standardized plans, each designated by a letter. They are labeled A through N, with each plan providing a different level of coverage. Supplement plans help ease the financial burden on patients.

For more information regarding the coverage provided by the parts of Medicare, give Advanced Insurance Concepts a call at 816-476-8191.