Medicare Explained

Original Medicare comes in two parts, A and B. Then, you can purchase additional Medicare coverage—Advantage, supplements, and/or Part D. Here is a closer look at what Medicare is and how to use it.

What’s Covered Under Original Medicare

Original Medicare (Parts A and B) covers a lot of necessary benefits for your health and wellbeing. Say, for instance, you are sent to the hospital for an emergency. With Part A, your stay and treatments will be covered. Every year you are given 60 days in the hospital or skilled nursing facility for emergency care, all you have to do is pay your deductible.

Say then, on your way to the hospital, you needed an ambulance. Well, under Part B, that service is covered, along with a huge variety of other benefits. Generally speaking, anything deemed “medically necessary” for treatment in an emergency or as told by your doctor will more than likely be covered. It can also include benefits such as preventative care and mental health services.

Adding Extra Coverage—What Are Your Options?

Once enrolled in Original Medicare, you’ll have a huge variety of other Medicare plans that you may add to it. This includes Medicare Advantage, supplements, and Part D.

Medicare Advantage features all of the same coverage as Parts A and B, and provides a network of healthcare providers to reduce your out-of-pocket costs, as well as some other additional benefits.

Medicare Supplements add a variety of out-of-pocket cost coverage to Original Medicare. This can include your deductibles, foreign travel emergency care, copayments/coinsurance, and more.

Part D covers prescription drug costs. Depending on the drugs you need and are prescribed, your coinsurance fee could be as little as $1-$3.

The Medicare Eligibility and Enrollment Process

Of course, before you can have any extra coverage, you have to be eligible and enroll first. To be eligible for Medicare, you must either:

  • Be 65 or older
  • Have End-Stage Renal Disease (ESRD) or Lou Gehrig’s Disease (ALS)
  • Have Received Social Security Disability Benefits for at Least 24 Months

When you first become eligible, you should receive a letter in the mail either informing you of your automatic enrollment in Original Medicare, or instructions on how to enroll. From there, in order to enroll in additional coverage, you will have to seek out eligible plans—a company like Iowa Illinois Senior Solutions will be very helpful in this case.

How Much Will You Pay for Medicare?

Costs for the different additional coverage options will vary depending on the provider. However, for Original Medicare, your costs will be the same as everyone else. In 2022, the premium for Part A is between $274 and $499. However, if you paid Social Security tax for at least 10 years, you are exempt from this fee, and will only have to pay the $1,556 deductible (which must be paid per benefit period).

For Part B, on the other hand, you will have to pay both your premium and deductible. In 2022, this premium is $170.10 and the deductible is $233.

Don’t Be Confused By Your Medicare Coverage—Call Iowa Illinois Senior Solutions

With so many caveats and clauses to Medicare, it can feel impossible to know how to manage your coverage. That’s why Iowa Illinois Senior Solutions is here. We offer real advice on even the toughest problems, and will take the time to walk you through your Medicare—call or email us today at 563-579-6116, or at jon@iailsenior.com.

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