The parts of Medicare (A, B, C, D)

Many of you know the various parts of Medicare, and what they cost and what they cover. But for some of you, you may want a refresher, especially in light of all the crazy phone calls, television commercials and flyers you may be receiving, promising you the moon, but really just potentially shuffling you into another plan to earn a commission and line their pockets.

Medicare Part A = covers hospital expenses, and costs you $0 monthly premium if you or your spouse have worked at least 10 years in this country, and paid into the system.

Medicare Part B = covers doctor expenses and anything done in a clinical setting (such as doctor appointments, lab work, x-rays, scans, etc.) Part B has a monthly premium of $170.10 (in 2022) for most people. If Medicare (the Federal government) decides you made too much money 2 years ago, they charge you more for your Part B premium. Part B is based on income, by looking back to tax returns filed 2 years ago (2020).

Medicare Part C = Part C is also known as an Advantage plan. Part “C” stands for “combined”. It combines Part A (hospital) and Part B (medical) into one plan and covers your hospital expenses, doctor expenses and in most plans prescription drug expenses, all in one convenient package. Many of these plans have $0 monthly premium and you just pay small copays whenever you have a service (ex: doctor’s appt, lab work, hospital stay, etc.) We call this type of plan “Pay As You Go”, because you only pay a copay IF or WHEN you receive a service. These plans may also offer additional benefits like over-the counter, transportation, vision and hearing not provided by Original Medicare (A & B).

Medicare Part D = this is a stand-alone prescription drug plan, and is usually used in conjunction with a Supplement plan for medical coverage. A Supplement plan (also known as a Medigap plan, as it fills in the gaps where A and B leave off) lets you see ANY doctor or go to ANY hospital, ANYWHERE in the United States, as long as that doctor or hospital accepts original Medicare Parts A & B. For the flexibility of being able to see just about any doctor in the US, Supplement plans have a monthly premium, and usually a deductible, and may or may not have additional copays after the deductible is met. The prescription drug plans have a monthly premium, and many times have an annual deductible.

I receive a fair number of calls each month saying, “What’s this plan I heard about that gives me back a bunch of money?” Or, “I received a call from someone who said I could be getting $3,000 a year of dental coverage, if I just switch my plan.
Is this real?” You need to understand that usually there are “NO free lunches”. Many of these promises of wonderful benefits are only available to someone who is on Medicare and their income is so low, they also qualify for Medi-Cal (Medicaid). Or they tell you that you can get $100 plus cash back each month towards your Part B premium, but what they don’t tell you is that this type of plan is not available in all areas, or it only applies to certain groups of people like veterans.

They get you interested, and then they sell you a different plan once they tell you that the plan you called about is not available to you. I’ve even had some people say that the person on the phone changed their plan without them even knowing it. That means they are no longer my client, their network (doctors) may have been changed and they are now stuck with an 800 number for service! Yikes!

If you have any questions about what type of plan you have, or about a solicitation you are
unsure of, please CONTACT US! Medicare is big business and you want to work with an agent who is knowledgeable about your market. An agent you can trust, that is looking out for YOU and YOUR NEEDS!