The ABCs of Medicare
There are four basic parts of Medicare: A, B, C and D. Each part helps pay for certain health care services. Each part also has certain costs that you may have to pay. Your Medicare costs will depend on what coverage you choose and on what health care services you use.
Peoples Health plans are Part C, Medicare Advantage plans, which require that our members are entitled to Medicare Part A and enrolled in Medicare Part B. All Peoples Health plans also include Part D prescription drug coverage.
Part A – Hospital Insurance
Part A hospital insurance covers inpatient hospital services, blood, skilled nursing facility care, home health and hospice care. Most people do not pay a premium for Part A services. For some services (e.g., inpatient hospital stays) they will need to pay a deductible before Medicare coverage begins. The deductible amount may change from year to year.
Part B – Medical Insurance
Part B medical insurance covers doctor, outpatient hospital, home health and preventive services, as well as other services Part A does not cover. You can choose if you want to enroll in Part B. Most people must pay a monthly premium to receive coverage. (This premium may be paid by other individuals or organizations if you qualify.) The premium amount may change from year to year and is based on annual income.
Part C – Medicare Advantage
Part C Medicare Advantage plans are paid by Medicare to administer health care coverage to people with Medicare. These plans must offer all the benefits of Medicare, but they can provide additional benefits and lower your out-of-pocket costs. Most Medicare Advantage plans also include Part D prescription drug coverage. To join a Part C Medicare Advantage plan, you must be enrolled in Medicare parts A and B.
Peoples Health is a Medicare Advantage organization that offers Medicare Advantage plans. Click here to learn more about Medicare Advantage plans and how they work.
Part D – Drug Coverage
Part D outpatient prescription drug coverage is optional coverage provided by private health insurance plans that contract with Medicare. Part D covers prescription drug costs and can be received by itself through a stand-alone prescription drug plan or through a Medicare Advantage prescription drug plan. Depending on the plan, there may be a premium associated with Part D prescription drug coverage. Plans can offer a “standard” benefit defined by law (or an equivalent benefit), which has a deductible, coinsurance payments and “the coverage gap” (also called “the doughnut hole”). Plans may also offer enhanced Part D coverage, which means there may be no deductible, drug costs may be lower or there may be partial coverage in the coverage gap.
What is Medicare supplemental insurance or a Medigap policy?
Supplemental insurance helps fill in the “gaps” for medical care that may not be covered by Medicare. It assists beneficiaries with costs for coinsurance, copays and deductibles. There is usually an additional premium that must be paid for supplemental insurance.