Medicare 101: A Simple Guide to Medicare Plans and Enrollment

As you near eligibility for Medicare, you’ll find that Medicare isn’t just a single plan. There are multiple options to choose from, and each type of Medicare plan has its own unique benefits when it comes to health insurance coverage. Here, we will delve into the different forms of Medicare and how you can enroll in them.

Medicare From Secure Insurance Group

Secure Insurance Group provides Medicare policies that give you the most out of your healthcare for the lowest price. We will help you find the exact policy you need to help you get the coverage you deserve.

What You Can Get From A Medicare Policy From Secure Insurance Group

Secure Insurance Group offers inpatient, outpatient, and drug plans from Medicare that will help you take care of your medical needs for a minimal cost. No matter what conditions you have or the treatments you need, Secure Insurance Group will help make your healthcare more affordable with its coverage.

What Are The Medicare Parts?

Medicare is divided into Parts, known as:

  • Part A
  • Part B
  • Part C
  • Part D

These cover different facets of medical care, with Part A covering inpatient services, Part B covering outpatient treatments, Part D providing coverage for medications, and Part C being a combination of Parts A, B, and D.

Medicare Parts A and B are commonly referred to as Original Medicare. Part C is also known as Medicare Advantage.

What Is Medicare Part A?

Medicare Part A provides coverage when you’re admitted as an inpatient in:

  • Hospitals
  • Skilled nursing facilities
  • Nursing homes
  • Hospice

This coverage can also apply in home health care settings.

The Part A costs for hospital stays are:

  • $1,600 deductible per benefit period. Benefit periods begin the day you’re admitted as an inpatient and end after a certain number of days you’ve gone without treatment (100 days for skilled nursing facilities, 60 days for hospitals)
  • Copayments ($0 for first 60 days, $400 per day for days 61-90, $800 per day for days 91-150, all expenses from day 151 onward)

The premium for Part A is $0 if you paid Medicare taxes for at least 10 years and sign up during the Initial Enrollment Period (three months before you turn 65 to three months after), but if you wait past the Initial Enrollment Period, the premiums can be $278 or $506 per month based on the duration you or your spouse worked and paid Medicare taxes.

When Can I Enroll In Part A?

If you don’t enroll during the Initial Enrollment Period, you can join during the General Enrollment Period, which is from January 1 to March 31.

What Is Medicare Part B?

Medicare Part B covers outpatient services, including:

  • Ambulance services
  • Durable medical equipment (DME) such as wheelchairs, canes, blood sugar test strips, and oxygen equipment
  • Preventive services, such as screenings
  • Any medically necessary service meant to diagnose or treat a medical condition

Part B costs include:

  • $226 yearly deductible
  • 20% coinsurance
  • $164.90 monthly premium (increases by 10% each year you wait to join Part B after becoming eligible)

When Can I Enroll In Part B?

Like Part A, you can enroll in Part B during the Initial Enrollment Period or General Enrollment Period.

What Is Medicare Part C?

Medicare Part C combines Medicare’s inpatient, outpatient, and prescription drug services into one plan. By law, Part C must cover everything that Original Medicare does.

Since Part C exclusively comes from private insurance, its coverage can vary from plan to plan. Such types of coverage that Part C has that Original Medicare doesn’t includes:

  • Gym memberships
  • Wellness plans
  • Dental, vision, and hearing care

Some Part C plans require policyholders to get coverage within a network, as opposed to Original Medicare, which provides coverage at any facility in the US that accepts Medicare assignment.

Part C’s costs also vary between insurance providers and types of plans, such as:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Special Needs Plan (SNP)
  • Private Fee-for-Service (PFFS)

This policy is ideal for those wanting an all-in-one coverage bundle, who prefer to get medical treatments within a network of providers.

When Can I Enroll In Part C?

You can enroll in Medicare Part C during the Initial Enrollment Period. You must already be enrolled in Original Medicare before you can join Medicare Part C. For example, if you miss the Initial Enrollment Period, you’ll have to join Original Medicare during the General Enrollment Period, and then switch from Original Medicare to Medicare Part C during the Open Enrollment Period (October 15 to December 7).

What Is Medicare Part D?

Medicare Part D offers drug coverage. Like Medicare Part C, it is a private insurance plan. Since it is a private insurance plan, each policy you find will cover a different set of medications. The list of medications a plan covers is known as a formulary.

Part D premiums and deductibles vary depending on the insurer. However, if you forgo joining Part D or go without creditable drug coverage (insurance with coverage comparable to Part D) for 63 days or more after joining Medicare, you will incur a late enrollment penalty. This penalty increases by 1% each month you go without drug coverage, and that percentage is then permanently added to your Part D premium.

Medicare Part D splits its formulary into tiers, which increase in price:

  • Tier 1 – generic, preferred medications (least expensive)
  • Tier 2 – brand-name, preferred medications
  • Tier 3 – brand-name, non-preferred medications
  • Tier 4 – specialty drugs (most expensive)

When Can I Enroll In Part D?

Much like the other Parts of Medicare, you can enroll in Part D during the Initial Enrollment Period. You can also join during the Open Enrollment Period as long as you have Original Medicare.

Find Out More Today

At Secure Insurance Group, we strive to help you get the Medicare plan you need, want, and deserve. With us, you’ll get the most out of what Medicare has to offer at the lowest possible price. We’re here for you, and you can get started today by calling us at 1-877-871-7328.