The United States has an aging problem. Before twenty years pass, there will be more old adults than children. This statistic exists primarily due to the massive Baby Boomer generation. Many Baby Boomers will soon become eligible for Medicare benefits and retirement if they aren’t already.
As the population ages, Medicare will likely become the primary provider of health insurance for years to come. Thus, understanding the different types of Medicare plans is critically important. Here’s what you need to know about this governmental healthcare provider for the aging.
What Is Medicare?
Medicare, as defined by its official government website, is a federal health insurance program. It’s like many of the healthcare plans provided by employers as part of a benefits package but funded by taxpayer dollars. It’s available to all Americans who are:
- At or over the age of 65
- Under 65, but suffering from certain disabilities
- Suffering from permanent kidney failure, or End-Stage Renal Disease
You may have seen people arguing in favor of (or against) Medicare for All. What this means is that they want insurance to work how Medicare works, but without its age-based or other restrictions.
What Types of Medicare Plans Are There?
If you’ve ever researched getting Medicare, whether it’s for yourself or someone else, you’ve likely seen references to different ‘parts’ of Medicare.
These may be called ‘parts’, but they refer to separate insurance plan types that can provide different levels of coverage for you. How do they work to provide coverage? We have the answers below.
Medicare Part A
All Medicare plans will include Part A insurance, which is also sometimes known as hospital insurance. As the name suggests, Medicare Part A plans cover only medical expenses related to skilled nursing care or hospitalization.
The good news? If you’ve worked over 40 calendar quarters in any job where you’ve paid into Social Security taxes, you won’t have to pay any premium for this service.
And if you’re worried about finding time for enrollment, don’t. You’re enrolled when you apply for Social Security!
Medicare Part B
Medicare Part B offers insurance coverage for most doctor and outpatient care. Notably, it only covers things deemed medically necessary. These can include:
- Preventive services
- Mental Health services
- Ambulance services
- Durable equipment
- A limited number of outpatient medications
Figuring out how much you’ll pay for Medicare Part B can be tough, but you can research online for more information. If you’re receiving any Railroad Retirement Board or Social Security benefits, you’ll automatically get enrolled in Medicare Part B.
Medicare Part C
Here’s where things get privatized. Medicare Part C, more often known as Medicare Advantage, is not provided by the federal government. Rather, you may buy it from a private insurance company once your enrollment for Medicare Parts A and B is complete.
Medicare Part C includes the coverages offered by parts A and B, with a few extra services. These services, depending on your provider, may include:
- Health and wellness programs and services
- Vision Insurance
- Dental Insurance
- Hearing Insurance
Some may also include prescription drug coverage. You’ll need to research your provider to discover what coverages your Medicare Part C plan is offering. Once you have this type of coverage, you’ll make all your payments directly to your insurance provider.
Medicare Part D
Like Medicare Part C, Medicare Part D is a private insurance addition to the government-provided parts A and B. Medicare Part D covers your prescription drugs. Which prescriptions are covered and which are not depends on your insurance provider. Make sure you research your entire prescription list thoroughly when choosing your Medicare Part D insurer!
What About Medicare Supplement Insurance?
When reading over this, you might have thought that Medicare Advantage plans sound like they ‘supplement’ Medicare. They must be the same as Medicare Supplement Insurance plans, right?
Not quite. Medicare Advantage keeps you enrolled in Medicare coverage. However, it provides your benefits and takes your payments from a third-party company. It essentially replaces and augments your standard Medicare policy.
Medicare Supplement Insurance policies serve as a stop-gap between the services Medicare covers and you being forced to pay out of pocket. It plugs the coverage gaps that Medicare Parts A and B leave open. As such, you cannot have a Medicare Supplement Insurance policy and a Medicare Advantage policy at the same time.
However, one thing to note: neither of these policies, in their basic forms, covers prescription drugs. So, whether you have Original Medicare and a supplemental insurance policy or Medicare Advantage, you’ll need to buy a separate Medicare Part D plan if you want any help in paying for your medications.
When Can You Enroll in Medicare?
Now that you’re familiar with the types of Medicare plans, you might wonder when you can enroll in Medicare. As mentioned above, certain Medicare options enroll you automatically when you start receiving Social Security benefits. However, the standard initial enrollment period occurs in the 6 months surrounding your 65th birthday.
If you somehow miss that window, you may enroll during either the General Enrollment Period between January 1st and March 31st. Or, failing that, you may enroll during Open Enrollment between October 15th and December 7th.
Understanding the different types of Medicare plans can be difficult. However, now that you know the difference between the ‘parts’ of Medicare and the various plans you can find on the market, you’ll have a better idea of what to look for.
If you enjoyed this article reviewing all the Medicare plans you can find and their benefits, check out the Health section of our blog for more content like this!