Medicare Part A
Medicare Part A is hospital insurance. It is provided by the government, usually with no monthly premiums for you to pay. Medicare Part A helps cover:
- Inpatient care in hospitals, including critical access hospitals and inpatient rehabilitation facilities
- Inpatient stays in a skilled nursing facility (not custodial or long-term care)
- Hospice care services
- Home health care services
- Inpatient care in a religious non-medical health care institution (coverage is related to non-medical, non-religious parts of care)
Medicare Part B
Medicare Part B is optional medical insurance for which you pay an additional monthly premium that usually comes out of your Social Security benefits. Medicare Part B helps cover:
- Doctors’ services, outpatient care, and other health care services that Medicare Part A does not cover.
- Services that are medically necessary for diagnosis or treatment of a condition
- Some preventive services to detect health problems early, such as physical exams, shots and screenings
- Some physical and occupational therapy to prevent or lessen complications from an existing medical problem
Keep in mind, if you don’t sign up for Medicare Part B coverage when you are 65, monthly premiums may cost you more each year. If you wait to sign up for Medicare Part B because you have a group health plan from a former employer, you may not have to pay a higher premium when you are ready to enroll.
Medicare Part A + Medicare Part B = Original Medicare
Medicare Part C
Medicare Part C is known as Medicare Advantage. To give you more options, the government allows companies like Aetna to help manage your Medicare Part A and Medicare Part B coverage together. This is called a Medicare Advantage plan, also sometimes known as a Medicare Part C or “MA” plan. When you select Medicare Part C instead of Original Medicare, you could get the same or greater benefits — and some extras like wellness, vision, hearing and dental care from the Medicare Advantage plan. You can enroll in a Medicare Advantage plan for a monthly plan premium. This plan premium is in addition to your Medicare Part B, and possibly Part A, premium.
You can choose from several Medicare Advantage plan options:
- Health Maintenance Organizations (HMOs) coordinate your care through a network of doctors and hospitals to lower your costs.
- Preferred-Provider Organizations (PPOs) offer all the benefits of an HMO with the added flexibility to choose doctors and hospitals in and outside of a network.
- Private Fee-for-Service Plans (PFFS) require no special networks or providers. You can visit any doctor or hospital that is eligible to receive payment from Medicare, agrees to treat you, and accepts the plan’s terms and conditions.
- Special Needs Plans (SNPs) are designed to meet the specific needs of Medicare beneficiaries who are also eligible for state Medicaid health insurance.
Medicare Part D
Medicare prescription drug coverage is called Medicare Part D. Everyone with Medicare can get prescription drug coverage. Like Medicare Advantage plans, Medicare Part D is only available from private companies such as Aetna. Each plan can vary in cost and drugs covered.
You have two choices for drug coverage under Medicare Part D:
- Prescription drug coverage as part of a Medicare Advantage plan (these plans are often called "MAPD" plans). This will give you all of your coverage in one plan, for one monthly plan premium (in addition to your Part B premium and Part A premium, if applicable) that often costs less than you would pay for each separately.
- A stand-alone Medicare prescription drug plan in addition to your existing Original Medicare (Medicare Part A or Medicare Part B) coverage, Medicare Supplement (Medigap) plan, or a Private Fee-for-Service (PFFS) plan without prescription drug coverage. These plans are sometimes referred to as "PDP" plans and only offer prescription drug coverage.
Medicare Supplement
You can add a Medicare Supplement plan (sometimes known as Medigap coverage). If you have Original Medicare, you can get coverage in addition to Medicare Part A and Medicare Part B that is provided by private companies like Aetna . This is called a Medicare Supplement plan. It helps you pay for some of the health care costs not covered by Original Medicare (Parts A and B), including deductibles and coinsurance payments. This type of coverage enables you to visit the doctors and hospitals of your choice.
Medicare Supplement Plans do not include prescription drug coverage. If you need prescription drug coverage, you can add a standalone Medicare Part D plan for an additional monthly plan premium.
