Doctor Explains Medicare A B D

I hope you can answer this question. Please explain Medicare and which Medicare plan I should pick for my parents?

Muddling through Medicare

Dear Medicare Muddler,

Thank you so much for your letter and I hope I can help.

The doctor explains Medicare has three parts: A, B, and D. Medicare part A pays for inpatient services such as hospital stays, treatment in inpatient rehabilitation and skilled nursing facilities, hospice care, and medical equipment. When a resident of the United States (or their spouse), who has paid into the Medicare system for at least 10 years, turns 65, he or she will automatically receive a Medicare part A card. With this card, the government will pay 80% of all inpatient services once the patient has met the deductible; the patient is responsible for the remaining 20%.

Medicare part B pays for outpatient services such as doctor’s visits, lab and radiology testing, and home health services in most situations. Medicare part B is optional. A patient can apply for Medicare part B at any time after the age of 65; premiums and deductibles may vary based on retirement income. With a Medicare part B card, the government will once again pay 80% of all outpatient services once the patient has met the deductible; the patient is responsible for the remaining 20%.

The doctor explains Medicare part D pays for prescription medication. Medicare part D must be purchased from a commercial insurance company as soon as a person turns 65, unless he or she has prescription benefits through an employer, the VA, or another entity. If a person does not purchase Medicare part D at the age of 65 and they do not have proof of alternate coverage, then later, at the time of purchase, insurance companies charge significantly higher monthly premiums to compensate for years of lost premiums.

Medicare part D is more complicated in terms of payment; there are three stages. In stage 1, they pay 80% of prescription drug costs up to a certain dollar amount; in stage 2, they pay 0% of the drug cost up to a certain dollar amount; in stage 3 they pay 100% of prescription drug costs till the end of the year.

The doctor explains that there are also Medicare advantage plans. Medicare advantage plans combine parts A, B, and C and can be bought from a commercial insurance company. They often offer advantages such as lower premiums and deductibles. They can cover dental services and provide discounts on hearing aids and dentures; some will also provide gym memberships and transportation to appointments. However, Medicare advantage plans often require the patients to pay higher copays when seeing specialists or a greater percentage of their hospital bill. They may also limit the physicians you can see to those in their network.

The Doctor

Doctor Explains Medicare