Parts A, B and D of Original Medicare have different coverages. Depending on your eligibility, your income, and your health conditions, you may apply for one or all of them. So, you may be wondering, what is the difference in Medicare parts A, B, and D?
Medicare is a health insurance program administered by the United States government. It is dedicated to people over 65 years old, or to young people with disabilities and/or end stage diseases.
Each year, there is an enrollment period, between October and December, to apply for a new plan or revise your current plan, whether you have part A, part B, or both.
Medicare part A
Medicare part A is the plan that includes hospital services such as hospitalization, skilled nursing facility care, and hospice.
Medicare part A is premium free for all those people that have worked for over 10 years and have paid Medicare taxes. If this is not the case, the policyholder will have to pay a monthly premium. However, part A still includes annual costs such as deductibles and copayments.
Medicare part B
Medicare part B is the plan that covers medical services, such as doctor’s visits, vaccinations, prevention evaluations, and laboratory tests. This plan includes a limited coverage of prescription drugs.
This plan is not premium free for all policyholders. For example, if you are 65 years old and are still working, you will have to pay a monthly premium. In this case, it is advised to hold and delay this coverage until the policyholder retires from work, and, if you have already paid the taxes required, apply only for Medicare part A.
What is not included in Medicare parts A and B
There are certain medical services that are not included in parts A and B of Medicare, like routine eye visits or dental care, hearing aids or personal nursing. To get this kind of coverage, there is Medicare Advantage, a category that offers four types of coverage.
With Medicare part A or B, you do not need to go to a primary doctor first to get a referral. These plans do not have a specialist network, but the policyholder must use providers that accept Medicare payments and terms. Otherwise, you would not get the benefits.
Medicare part D
The difference in Medicare part D is that it works alongside the other plans. It has a monthly premium, out of pocket annual costs, and covers more specifically prescription drug costs (that are not included, for example, in Medicare parts A or B).
Medicare part A covers prescription drugs for treatment during inpatient hospital or skilled nursing facility stay. Part B would cover certain medications you get in an outpatient setting, such as a doctor’s office. However, these are usually prescription drugs you can’t administer without a doctor.
If you have other coverage
If you already have insurance through your employer or other kind of policy like COBRA, Medicare will work alongside these to decide who pays first. Usually, they divide the costs.
How to get financial assistance
If you have low income and you need financial assistance to pay all the annual costs of parts A and B of Medicare, you can check if you are eligible to apply for a Medicare Savings Program.
If you need help with covering the costs of part D of Medicare, you can get extra help with the Low-Income Subsidy. Both this and the Medicare Savings Program are administered by Medicaid.
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