MEDICARE 101
Seniors 65 and older and those under 65 who have been disabled for more than 24 months may be able to acquire Medicare benefits.
Know your parts
Original Medicare
PART A
Known as "Hospital Insurance," this portion of Medicare coverage serves to cover hospital expenses such as:
inpatient care
skilled nursing care
hospice
home health care, etc.
This coverage is generally "free" because beneficiaries have paid Medicare taxes throughout their employment history.
One can pay full price for the Part A premium if one is not eligible.
PART B
Part B covers basic medical expenses rendered at a medical facility
such as:
doctor Visits
Specialist visits
durable medical equipment, ambulance services, etc.
Every beneficiary must pay a monthly premium, which in 2024 is $174.70.
Consumers eligible for Medicaid (Medi-Cal) will not pay this premium as the low-income program covers the expense.
Nearly 4.4 Million Americans will turn 65 in 2024
Know your parts
(Continued)
PART D
This portion of Medicare covers prescription drug costs at an additional monthly premium.
Various private health companies are contracted to sell Part D plans, each with a formulary and monthly premium.
Medicaid (Medi-Cal) will cover this monthly expense if eligible for the program.
Medicare supplement
(medi-Gap)
Apart from the Part B premium, original Medicare (Part A and Part B) comes with a 20% coinsurance cost for each medical service.
Medi-gap coverage helps to cover the expenses that will fill in those coverage gaps and help offset the costs of original Medicare.
Various private health companies are contracted to offer such plans but at an additional premium. Some offer additional coverage, like vision and dental.
Penalties will ensue if a consumer does not enroll in Medicare once eligible.
(Certain exceptions are available)
Know your parts
(Final)
PART C
(Medicare Advantage)
One of the better-known aspects of Medicare is the Part C plan.
This is a combo benefit that includes...
part A + Part B + Part D
These are also run by private insurance companies, and most offer them at no additional monthly premium.
These plans may include extra benefits not covered under original Medicare, like dental, vision, chiropractic care, and even Part B reimbursements.
Part E
(PACE plans)
Program of all-inclusive care for the elderly is what Pace stands for.
These plans are reserved for patients with extensive medical needs who require a nursing home level of care.
One must have both Medicaid (Medi-Cal) and be eligible for Medicare to apply, reside in the plan's service area, and be at least 55.
