Medicare is a federal health insurance program created for people at least 65 years or with certain disabilities. Medicare is divided into four parts – A, B, C, and D. Here is everything you need to know about the cost and coverage of each package.
Medicare Part A
Medicare Part A, or hospital insurance, is part of original Medicare. When you turn 65, you become eligible for Part A. Ideally, people below 65 can still qualify for this part of Medicare, depending on disability status.
What Medicare Part A Covers
Hospital insurance covers the following:
- Inpatient care in a hospital
- Skilled nursing facility care
- Hospice care
- Inpatient care in a skilled nursing facility
You should, however, note that Part A neither offers coverage for long-term care services nor custodial care in nursing homes or assisted living facilities.
The Cost of Medicare Part A
Although a good number of people get Part A free of charge, in 2023, you can buy it for $506 every month if you do not qualify for the premium-free version. In 2023, hospital insurance has $1,600 as its deductible, and it is important to note that while several inpatient services do not have copays to start, they apply after a particular period. You should also note that the out-of-the-pocket costs of Part A have no annual limit. However, you can buy a Medicare Supplement Insurance plan separately to limit these costs.
Medicare Part B
Medicare Part B is also part of original Medicare, and you are eligible for it if you are also eligible for premium-free hospital insurance. Ideally, U.S. citizens or certain legal residents of at least 65 years can still be eligible for outpatient medical insurance, even if they are ineligible for premium-free hospital insurance.
What Medicare Part B Covers
Outpatient medical insurance offers coverage for a couple of different services that are preventive services and outpatient healthcare services. The following are examples of outpatient healthcare services Part B covers:
- Durable medical equipment such as wheelchairs, lift chair mechanisms, and CPAP machines
- Mental health services
- Certain inpatient services like X-rays or stitches
- Visits to a healthcare provider at a clinic or office
Preventive services that Part B covers include such things as tests, counseling, vaccines, and screenings.
The Cost of Medicare Part B
Outpatient medical insurance has a deductible, a premium, and coinsurance requirements. They are as follows:
- Deductible: In 2023, deductibles under Part B are $226
- Premiums: In 2023, most people are charged the standard premium of $164.90 every month. However, you are likely to pay more if your income is high.
- Cost sharing: While there is 20% coinsurance for outpatient services, there is no copay or coinsurance for most preventive care.
Medicare Part C
You can buy Medicare Part C plans from private insurance companies. Part C is also referred to as Medicare Advantage.
What Medicare Part C Covers
The benefits of Medicare Part C vary, depending on the plan. However, all Part C plans have to cover at least similar benefits offered in Parts A and B. In most cases, a Medicare Advantage plan will provide the same benefits as original Medicare – Parts A and B – and more. Normally, a Medicare Advantage plan includes prescription drug coverage and several additional hearing, dental, and vision care benefits. However, these plans might not cover the stair lift or the installation of the stair lift according to this page.
The Cost of Medicare Part C
You are still responsible for outpatient medical insurance premiums of $164.90 every month in 2023 if you buy a Part C plan. Below are the Part C costs:
- Cost sharing: Coinsurance and copays vary by plan
- Deductible: Deductibles range from plan to plan
- Premiums: According to the Centers for Medicare & Medicaid Services, the average Part C premium is expected to be around $18 monthly in 2023. Premiums vary from $0 to $100 every month.
Medicare Part D
You can buy Part D from private insurance companies to get prescription drug coverage. The two diverse ways to get it are based on whether you have a Part C plan or original Medicare.
- Since the Part C plan always includes prescription drug coverage, you are unlikely to join a separate Part D plan if you have it.
- If you have original Medicare, you can go for a stand-alone Part D plan.
What Medicare Part D Covers
Every Part D plan and Part C plan with prescription drug coverage has a list of covered drugs or a formulary. As such, you should check the formulary to find out whether a plan covers the medications recommended for you and how it does it.
Most formularies are divided into tiers, where each tier has different requirements for cost-sharing. For example, lower-tiered drugs have low cost-sharing requirements, whereas higher-tiered drugs are likely to cost more out of pocket.
The Cost of Medicare Part D
Part D can have deductibles, premiums, copays, and/or coinsurance.
- Deductible: Most Part D plans have deductibles for some or all the drugs they cover. According to the law, the deductible cannot surpass $505 in 2023.
- Premiums: Basic stand-alone Part D coverage has an average premium of $31.50 every month in 2023.
- Cost sharing: The formulary of each plan describes the coinsurance and/or copays for drugs on every tier.