Medicare Parts A and B: What You Need To Know

Turning 65 is a significant milestone in your life, bringing not just the joy of aging but also the opportunity to enroll in Medicare for the first time. For many, this new chapter can feel overwhelming, but understanding the basics of Traditional Medicare—Parts A and B—can empower you to make informed decisions about your healthcare coverage.

What is Traditional Medicare? Traditional Medicare, also known as Original Medicare, is a federal health insurance program designed primarily for individuals aged 65 and older. It comprises two main parts: Part A and Part B, each serving distinct purposes to help manage your healthcare needs.

Deep Dive into Medicare Part A: Medicare Part A is essentially your hospital insurance. Here’s what you need to know about its coverage:

• Inpatient Hospital Stays: Part A covers the cost of a semi-private room, meals, general nursing, and necessary hospital services and supplies. However, it does not cover personal care items or private-duty nursing.
• Skilled Nursing Facility Care: If you require specialized nursing care after a hospital stay, Part A can cover up to 100 days in a skilled nursing facility, provided certain conditions are met.
• Hospice Care: Part A also covers hospice care for individuals diagnosed with terminal illnesses, focusing on comfort and quality of life rather than curative treatment.
• Home Health Care: For those needing home-based medical services, Part A may cover limited home health care services.

Costs Associated with Part A: Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working. However, it’s essential to understand the deductibles and coinsurance associated with this coverage. You will incur a deductible for each benefit period, and coinsurance may apply after a certain number of days in the hospital or skilled nursing facility.

Exploring Medicare Part B: Medicare Part B covers your medical insurance, which is crucial for outpatient care. Here’s a closer look:

• Doctor Visits and Outpatient Care: Part B covers medically necessary services like doctor visits and outpatient care that Part A does not.
• Preventive Services: This part includes coverage for preventive services like flu shots, screenings, and annual wellness visits, helping you stay healthy and catch potential issues early.
• Durable Medical Equipment (DME): Part B covers certain medical equipment, such as wheelchairs, walkers, and oxygen equipment, which can significantly enhance your quality of life.

Costs Associated with Part B: Most individuals pay a standard monthly premium for Part B, which can vary based on income. After meeting the annual deductible, you will typically pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment.

As you approach 65, taking the time to understand your options with Medicare is crucial. Assess your healthcare needs and consider how Parts A and B fit into your overall healthcare strategy. 

Schedule your appointment with us today: BOOK HERE