What Medicare Coverage Do I Have? - Medicare Consumer - Medicare Consumer

What Medicare Coverage Do I Have?

There are several different “parts” to Medicare, and each can offer different types of services. Knowing which benefits you have is important in determining the coverage that you are – and are not – eligible for.

Medicare is divided into four parts. These are:

  • Part A – Hospital Coverage. This part of Medicare coverage will help to pay for inpatient care in a hospital or in a skilled nursing home (following a hospital stay). It also covers some types of home health care, as well as some hospice care.
  • Part B – Medical Coverage. This part of Medicare helps to pay for doctors’ services, as well as numerous other services and supplies that are not covered in Part A.
  • Part C – Medicare Advantage Plans. Medicare Part C is also referred to as Medicare Advantage. It offers an alternate way of receiving one’s Medicare Part A and B coverage, as well as additional benefits that are not offered in Medicare Parts A and B.
  • Part D – Prescription Drug Coverage. This part of Medicare helps to pay for prescription drugs that doctors prescribe for the treatment of a patient.

Medicare provides Part A coverage, while Part B is optional. Medicare Parts A and B are considered “Original Medicare.” With Original Medicare, individuals can choose their own doctors and other health care providers.

Part C of Medicare, or Medicare Advantage, is a type of health care plan that is offered through private insurance companies that contract with Medicare in order to provide all of the Part A and Part B benefits. These plans will typically offer additional coverage as well, such as dental and vision care.

Medicare Advantage plans oftentimes include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service Plans (PFFSs), Special Needs Plans (SNPs), and Medicare Medical Savings Account Plans (MSAs). If you are enrolled in a Medicare Advantage plan, then most of your Medicare services will be covered through the plan and they won’t be paid via Original Medicare (Part A and Part B). Many of the Medicare Advantage plans will also offer prescription drug coverage.

Because Medicare Advantage plans are offered by private insurance companies, the benefits may differ from one plan to another, as well as from one location to another. The premium cost of each plan may also be different, unlike the monthly premium for Medicare Part B.

Part D of Medicare offers prescription drug coverage. These plans can be purchased in conjunction with Original Medicare (Medicare Part A and Part B), or alternatively, this coverage could already be included within a Medicare Advantage plan.

These plans are offered by private insurance companies. Therefore, the benefits that are offered can differ from one Part D plan to another. Likewise, the premiums that are charged for Medicare Part D prescription drug coverage plans can also differ from plan to plan.

 

Ensuring Your Medicare Coverage

If you still are not sure of the Medicare coverage that you have, you can either check your red, white, and blue Medicare card. Or, alternatively, check any other insurance cards that you may use and call the phone number that is listed on the card in order to obtain additional information regarding the coverage. You may also contact Medicare directly by calling 1-800-633-4227.

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