Medicare has four parts, each with its own rules and coverage area. Eaton Agency is here to help you understand the language and definitions involved in modern-day Medicare. Our goal is for clients to understand the programs offered and how they will fit into a healthcare coverage plan.
Medicare Parts Explained
- Part A: inpatient/hospital coverage
- Part B: outpatient/medical coverage
- Part C: alternate way to receive Medicare benefits
- Part D: prescription drug coverage
Most beneficiaries of Medicare choose Part A and Part B benefits. This is the traditional fee-for-service program offered from the federal government. The government pays directly for healthcare services received. Beneficiaries will be covered by any doctor or hospital that takes traditional medicare.
Other facts about traditional Medicare:
- You do not need prior permission/authorization to see a doctor or visit a hospital.
- You must pay a monthly premium for Part B, and some are required to pay a premium for Part A.
- Beneficiaries typically pay a coinsurance for services.
- If you want prescription drug coverage with Medicare, you will need to sign up for a stand-alone Medicare private drug plan.
- There are government programs available to help reduce your healthcare and prescription drug costs if you meet eligibility requirements.
Medicare Advantage Plans fall under Medicare Part C. Beneficiaries can decide to receive their Medicare benefits through a private health plan. You still have Part A and Part B Medicare when you choose to enroll in Part C. Beneficiaries will still pay a monthly premium for Part B, and some will have a premium for Part A as well. Beneficiaries with Part C have an advantage plan with a private insurer to cover Part A and Part B but with different rules, costs, and restrictions.
Eaton Agency knows the importance of understanding Medicare coverage choices and picking coverage carefully. We are here to discuss program benefits, out-of-pocket costs, network and provider access, and additional coverage such as dental and vision.
