The ABCs of Medicare Plans

If you’re nearing age 65, now is a good time to learn what each letter of the Medicare alphabet means.

by NEA Member Benefits

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Key takeaways

  • Original Medicare consists of Part A hospitalization and Part B medical coverage.
  • Part D covers prescription drugs and premiums vary by benefit plans and insurance companies.
  • Part C, Medicare Advantage, takes the place of Original Medicare.
  • Medigap policies pay the 20% of charges that Parts A and B do not cover.

Medicare is divided into different parts, each with a letter identifier. Here’s a quick overview of the basic parts, what each part covers and approximate costs.

Medicare

What it’s for

What it costs

Part A

Hospitalization

Premium-free for anyone who paid Medicare taxes through their employer for at least 10 years

Part B

Medical insurance for doctor’s visits and outpatient services

Monthly premiums vary, depending on income

Part C (Medicare Advantage)

Hospitalization, medical services and prescription drugs, plus other health services

Premiums vary by plan and benefits provided

Part D

Prescription drugs

Premiums vary by plan and benefits provided

According to Marian Solomon, Senior Program Specialist with NEA Member Benefits, Original Medicare (Parts A and B) will cover 80% of your hospital and medical expenses. In 2018, you’ll have to pay a benefit-period deductible of $1,340 for Part A and a calendar-year deductible of $183 for Part B. But it can get more complicated than that depending on the length of a hospital stay and what type of facility you receive care in, among other factors. You can sort out all the variables at medicare.gov.

Supplementing your Parts A and B coverage

If you want to fill in that 20% A and B coverage gap, you have two basic options.

  • Medicare Supplement Insurance (Medigap). Medigap policies are offered by private insurance companies and must follow Medicare rules. These policies supplement your Part A and Part B coverage by paying for the 20% those parts don’t cover. Medigap policies also may pay for the Parts A and B deductible and copays. They come in 10 varieties, labeled A-D, F, G, K and L-N. Each lettered plan offers different benefit levels and premiums. The NEA offers supplement plans to members. “Plans C, F, L, and N are often selected but Plan F is our most popular plan,” Solomon says. Medigap policies do not cover prescription drugs.
  • Medicare Advantage Plans. These plans are offered by private insurance companies that contract with Medicare. The plans provide all of your Part A and Part B benefits and most provide prescription drug coverage. Most also cover vision, hearing and dental care, along with some health and wellness programs. Aside from potential copays and deductibles, Advantage Plans generally are designed to cover 100% of your health care costs, although in certain cases, they may only cover 80%. If you join a Medicare Advantage Plan, you will continue to pay your Medicare Part B premium on top of your Advantage Plan premium, if there is one. Not all Medicare Advantage Plans work the same way—some don’t charge monthly premiums depending on the coverages offered— so shop around. 

Covering your drug costs

If you stick with Original Medicare Parts A and B and want prescription drug coverage, you’ll need to purchase a Part D plan, whether you buy a Medigap policy or not. Like a Medigap policy, Part D insurance is offered by private insurance companies. The plans vary in the drugs that are covered, deductibles and copays. Shop around to find a plan with the benefits you need at a price you can afford.

Shopping for Medicare plans

Health insurance is always a complicated subject. There are so many variables involved and each one affects your benefits and your costs. As you can see, Medicare is no exception.  The simplest option is to go with Original Medicare A and B. You’ll pay a monthly premium for Part B and you’ll have deductibles and copays. And you’ll be on the hook for 20% of your health care costs. Once you move beyond that basic coverage you’ll need to shop around and do a lot of research. Get started by searching and comparing plans here.


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