Medicare 101

When you turn 65 and enroll in Medicare, this is what you get from the Government:

Part A (Hospital Insurance)
Helps Cover:

• Inpatient care in hospitals
• Skilled nursing facility care
• Home health care

Monthly Costs
Most people dont pay a monthly premium for Part A.  If you worked more than 40 quarters in the U.S. then you should receive premium free medicare part A. If you paid Medicare taxes for 30-39 quarters, the standard part A premium is $252. If you paid Medicare taxes for less than 30 quarters, you’ll pay $458.

Deductible and Coinsurance

• $1,408 deductible for each benefit period
• Days 1-60: $0 coinsurance for each benefit period
• Days 61-90: $352 coinsurance per day of each benefit period
• Days 91 and beyond: $704 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)
• Beyond lifetime reserve days: all costs

Part B (Medical Insurance)
Helps cover:

• Services from doctors and other health care providers
• Outpatient care
• Home health care
• Durable medical equipment
• Preventive services

Monthly Costs
The standard Part B premium amount is $144.60 ( or higher depending on your income).

Deductible and Coinsurance

• $198 deductible.
• After your deductible is met, you typically pay 20% of the Medicare approved amount.  

In addition to Medicare Part A and B from the government, when you turn 65 and enroll in Medicare, this is what you purchase from an insurance company:

Medicare Supplement

• Covers things that Medicare part A and B doesn’t
• you can see any doctor or specialist who accepts Medicare without a referral
• better for seniors who live in multiple states or travel more frequently
• Does not include coverage for prescription drugs
• Costs more per month than Medicare Advantage 
• Prices increase faster than Medicare Advantage

Medicare Advantage

• Covers things that Medicare Part A and B doesnt
• You will have a primary care doctor and need referrals to see your specialist
• Better for seniors who live in one place and travel less frequently
• Includes coverage for prescription drugs
• Can include extra benefits for things like: dental, vision, Chiro, gym membership, hearing aids, over-the-counter drugs
• Costs less per month than Medicare Supplement
• Costs increase slower than Medicare Advantage

Summary
Because the Medicare program was never designed to cover 100% of medical costs, most Medicare beneficiaries will enroll in a Medicare Supplement Plan or Medicare Advantage Plan.  Deciding between a Medicare Advantage Plan and Medicare Supplement Plan is a very nuanced and personal decision.  Take your time when considering these two options as once you choose, you may or may not be able to change your mind.