Do you have,or are you considering signing up for Medicare? If so, it’s important to make sure you understand the four different parts of Medicare to help prevent confusion and delay in getting the care you need. In our blog What is Medicare?, we gave you a high level overview of the four different parts. Now we’re going to dive deeper into Medicare Part A and Part B, touching on who is eligible and what each does and does not cover.
Who is Eligible for Medicare Part A and B?
Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) are available to those eligible, which include:
- Age 65+
- End-Stage Renal Disease (ESRD)
What is Medicare Part A?
Medicare Part A is for hospital insurance. This means that it will help pay for many items that fall under hospital and facility costs. Items typically covered under Part A include:
- Hospital care
- Skilled nursing facility care
- Nursing home care
- Home health services
According to Medicare.gov, you usually don’t pay a monthly premium for Medicare Part A coverage if you or your spouse paid Medicare taxes while working. This is sometimes called “premium-free Part A.” If you buy Part A, you’ll pay up to $413 each month in 2017.
What is Medicare Part B?
As noted above, Medicare Part B is for medical insurance. This means that it will help pay for medical costs outside of the hospital. Items typically covered under Part B include medically necessary services and preventative services such as:
- Doctor visits
- Clinical research
- Diagnostic testing
- Outpatient procedures
- Ambulance services
- Durable medical equipment
- Flu shots (or other vaccines)
- Mental health (outpatient, inpatient or partial hospitalization)
According to Medicare.gov, the standard Part B premium amount is $134 (or higher depending on your income). However, most people who get Social Security benefits will pay less than this amount ($109 on average).
What is Not Covered by Medicare Part A or Part B?
Some items that you can anticipate not being covered by Medicare include:
- Long-term care
- Most dental care
- Eye examinations related to prescribing glasses
- Cosmetic surgery
- Hearing aids and exams for fitting them
- Routine foot care
In some cases, you may find Medicare will cover one of the items listed above, but you will most likely pay co-payments, coinsurance, or a deductible. So always check with your physician, provider, and Medicare insurer before getting any procedures done. Keep in mind that the cost of Part A or Part B can vary if you do not sign up when eligible.
As you approach the age of 65, you should follow the steps outlined here to ensure you are enrolled on time and get the right coverage for your needs. Don’t miss out on any healthcare coverage or savings. Share this with your friends and loved ones so everyone is properly covered and understands Medicare Part A and Part B.