Welcome to Medicare School Daily, where we help you understand Medicare,
save money, avoid mistakes, and above all else, get the most out of your Medicare benefits. Now,
today's topic is: what are the four types of Medicare? Meaning when you go on Medicare, what
are the different types within the Medicare system we’ll be using for your health care? So these
would be the different parts of Medicare, and there's actually four different parts of Medicare,
four different types of your health care coverage. Number one, we begin with parts A and parts B,
so this would be two of the four. We call parts A and parts B, original Medicare, Original Medicare.
Right? And it's broken up that these two parts, Part A is pretty much everything that would be
inpatient type services; part B pretty much everything outpatient. So that's going to be
the difference. Now, on the Medicare card part A is actually called the hospital,
and Part B is called medical. Alright? Now for the majority of people, when you enroll in Part A,
there's no premium for that. You've been paying into the Medicare tax system for at
least 10 years, 40 quarters. There's no charge for part A. Now, Part B does have a premium,
and that premium is paid either through your Social Security check or they bill
you for that on a quarterly basis. But that's called the medical.
So there's always a premium for part B, so that's the two original parts of Medicare. Now in this
A and B type coverage, it is really very good. But you're going to see that Medicare
is not going to pay for anything 100 percent other than preventive. So Medicare does pay
well, but they don't pay for everything. And so there are gaps in both A and B. In other words,
there's some financial liabilities that you have. That could be a deductible, it could be a co-pays;
it could be coinsurance. But those are the gaps in original Medicare A and B,
things that you're going to be responsible to pay for. So the majority of people, instead of just
having A and B only are going to typically buy a supplemental plan. These are also called Medigap
policies. These are purchased from private health insurance companies. And of course,
what you're doing is transferring the liability of the gaps to that private health insurance company.
And you're going to pay them a premium to take that liability. All of these supplemental
plans are represented by letter. Presently there's 10 different letters, those are A, B,
C, D, F, G, K, L, M, and N. 10 different letters. 10 different types of coverages for Medigap
policies. The most common today are the F, the G, and the N. That's what most people are buying.
And so the whole point is: these are filling in the gaps where A and B did not pay,
these companies, private health insurance companies, will then pay a portion of those
bills. And of course, you have to pay them a premium for them to take on that liability.
All right? So that's supplemental plans, supplementing original Medicare A and B
And then that takes us to the third part of Medicare, which are called Part C plans. These
are also called advantage plans. These are private health insurance companies that are, watch,
what they're doing is they're replacing original Medicare A and B,
so A and B, remember is you're in and outpatient care. So when someone buys an advantage plan,
what's happening is they're having a private health insurance company that's replacing their
in and outpatient care. So in this example, a private health insurance company is going to cover
the in an outpatient, you'll be responsible for some coinsurance, maybe some co-pays on the
plan. But then the balance of that is not paid by Medicare, the balance has been paid by the private
health insurance company. All right? And really, the only two things that these have in common is
if I have a supplemental plan or an advantage plan, I am still paying my part B premium,
member that's taken out of your Social Security check or it's billed to you on a quarterly basis.
So we always have to pay Part B if I use a supplemental plan
or if I use an advantage plan. So those are our options for in and
outpatient. Either we stay in the original Medicare A and B and or we get a C plan,
which is then will be a replacement of original Medicare A and B. All right.
And then that takes us to the final part of Medicare, which are called Part D plans,
or these are prescription drug plans. Now, original Medicare A and B, we do have some
medications covered, but it would only be meds that were taken in the hospital
or in an outpatient facility, chemotherapy or maybe Prolia shots or infusion or injections.
The Part A will pay for meds that are administered to us while we're in the hospital. So the Part D
plans, those are for when we're self-administering medication, this would be for your heart meds or
cholesterol, insulin, those kinds of meds that you're going to take at home, where you're going
to go to the pharmacy to pick those prescriptions up. Those are not covered by A and B,
those are covered by Part D plans. And so there's one of two ways you will buy a Part D plan.
If you decide to go with the supplemental option. What will happen is you're going to have what we
call a separate or a standalone prescription drug plan. That standalone drug plan is going to have
a separate policy and a separate premium. If you decide to do in a replacement plan,
meaning you decide to have an advantage plan, then what's going to happen is you will be given
the option to have an embedded prescription drug plan. In other words, it's part of the package.
So that advantage plan is covering you for inpatient and outpatient, but they're also gonna
cover you for prescription drugs. And either way you go here, the way these work with drug plans is
you almost always have a deductible, and then you also have co-pays for most of your medications as
well. All right? And so that's the way your drug plans are going to be covered, either separate or
embedded. So those are the four parts of Medicare. And so as you go on Medicare and you're looking at
your different options, if you would like one of our Medicare school guides to walk you through
this whole process and explain all your different options with supplemental plans and advantage
plans and prescription drug plans, it would be our privilege to walk you through that whole process.