People sometimes joke that learning about Medicare is like learning a new language, and, hey, it can certainly feel that way, right? But there is a bit of truth to it too. Just as you learn English as a child, understanding Medicare starts with the same four letters: A, B, C and D.
These letters are the building blocks of Medicare, according to UnitedHealthcare. So what do these letters mean in terms of coverage?
Medicare Part A helps with costs associated with inpatient care, such as when you're admitted to a hospital or skilled nursing facility. Costs may not be covered by Part A if you are in the hospital for observation. Part A covers charges from the inpatient facility as well as most of the services you receive while there. It does not cover the fees doctors charge for participating in your care or if you’re treated in the hospital under observation status. This brings us to Part B.
Medicare Part B helps with costs associated with outpatient care, such as doctor visits. It also covers most doctor services you receive while you're an inpatient at the hospital or other care facility. Part B covers some preventive care, like flu shots, along with outpatient clinical laboratory services, like blood and urine tests.
Together, Medicare Parts A and B make up Original Medicare — coverage administered by the federal government. You can bolster Original Medicare coverage with Medicare supplement insurance, or Medigap. These add-on private insurance plans help offset costs Original Medicare doesn't cover, such as deductibles and coinsurance.
In order to offer more choices to beneficiaries, though, Congress added Parts C and D to the Medicare program.
Medicare Part C is also known as Medicare Advantage. In order to join a Medicare Advantage plan, which are offered by private insurance companies, you must be enrolled in Part A and Part B. Accordingly, Medicare Advantage plans provide everything you get with Original Medicare and may offer additional benefits. These benefits may include coverage for dental, vision, hearing care and even prescription drug coverage.
Medicare Part D is prescription drug coverage. Also offered by private insurance companies, Part D coverage can be secured through a standalone plan added to Original Medicare or through a Medicare Advantage (Part C) plan. Most Medicare Advantage plans include prescription drug coverage, allowing people to get all of their coverage – Parts A, B and D – wrapped into one plan.
Although Part D plans are required to cover certain types of drugs, each plan chooses which specific drugs to cover. Therefore it is important to carefully review a plan's list of covereddrugs, or formulary, to ensure any prescription drugs you take regularly are included.
If that seems like a lot of alphabet soup to digest, remember that there's always a learning curve when mastering a new "language." And also keep in mind that you’re not permanently locked into a plan. You can change your coverage choices during Medicare Open Enrollment, Oct. 15 through Dec. 7, so if you’re not totally satisfied with your current coverage, you’ll have the chance to switch to a plan that better fits your needs.
This post is sponsored by UnitedHealthcare. For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.
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