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About Medicare 

Medicare Has Four Parts Categorized by Letter Designations.



Medicare Part A is your hospital insurance and helps cover medical expenses while you are staying in a hospital setting. Your exposure with Medicare Part A includes deductibles, coinsurance and co-pay expenses that can become pretty significant if you do not have supplemental coverage to Medicare. You will automatically be entitled to, and enrolled in, Part A at age 65 if you worked 40 quarters in the United States. You can also qualify for coverage through a spouse that worked 40 quarters. 


Medicare Part B is coverage for outpatient medical services. You are exposed to a deductible, coinsurance, co-pays and excess charges if you don’t have a supplement for Medicare. This coverage is elective but most Medicare recipients take it. You will pay a monthly premium for Medicare Part B that will be based on your income level. 



Medicare Part C is a privatized plan that is also known as Medicare Advantage. You can choose to take this plan offered by private health insurers instead of Original Medicare. Although there are some benefits to this plan in that it is required to cover you as well as or better than Original Medicare, you will typically find that fewer doctors and hospitals accept this type of policy. Additionally, there isn’t a reliable way to supplement coverage for the out-of-pocket expenses in this plan. You will still have to pay your Medicare Part B premiums to own this type of policy and may pay anywhere from $0 additional to over $100/month for this type of plan. If you have a Medicare Advantage Plan, you will not be able to buy a Medicare Supplemental Insurance plan as Medicare Supplements are not intended to cover the gaps in Medicare Advantage plans.



Medicare Part D was introduced in 2006 as a component of the Medicare Modernization Act of 2003. It provides coverage for prescription drug costs and is elective coverage. If you don’t take it when you are initially eligible and decide to enroll later, you can face some fairly stiff penalties. These plans have minimal standardization when it comes to important things like premiums, co-pays, coinsurance, deductibles and which drugs they’ll cover (known as formularies). Some may also be more restrictive than others in requiring step-therapy or limiting the amount you can order each month. The best way to determine which drug plan to enroll in is to call your local SHIIP representative or by contacting NC SHIIP (Seniors' Health Insurance Information Program) at (800) 443-9354 or visit the Medicare website at www.medicare.gov and use the Prescription Drug Plan Finder Tool.

2019 Medicare Part A & Part B Premiums & Deductibles

Medicare Part B Premiums/Deductibles

Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.  

The standard monthly premium for Medicare Part B enrollees will be $135.50 for 2019, an increase of $1.50 from $134 in 2018. An estimated 2 million Medicare beneficiaries (about 3.5%) will pay less than the full Part B standard monthly premium amount in 2019 due to the legal hold harmless provision, which limits certain beneficiaries’ increase in their Part B premium to be no greater than the increase in their Social Security benefits. The annual deductible for all Medicare Part B beneficiaries is $185 in 2019, an increase of $2 from the annual deductible $183 in 2018.

Medicare Part A Premiums/Deductibles

Medicare Part A inpatient hospital deductible that beneficiaries will pay when admitted to the hospital will be $1,364 in 2019, an increase of $24 from $1,340 in 2018. Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. In 2019, beneficiaries must pay a coinsurance amount of $341 per day for the 61st through the 90th day of hospitalization ($335 in 2018) in a benefit period and $682 per day for lifetime reserve days ($670 in 2018). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $170.50 in 2019 ($167.50 in 2018).

 

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