Medicare consists of 4 parts that are Part A (Hospital Insurance), Part B (Medicare Insurance), Part C (Medicare Advantage Plans), and Part D (Medicare drug coverage).
Part A (Hospital Insurance) gives inpatient/hospital coverage.
Part B (Medicare Insurance) provides outpatient/medical coverage.
Part C (Medicare Advantage Plans) offers an alternative way to get your Medicare benefits (see below for more details).
Part D (Medicare drug coverage) gives prescription medication coverage.
Typically, the different parts of Medicare help cover specific services. Many beneficiaries select to receive their Parts A and B benefits with Original Medicare, the typical fee-for-service plans provided directly via the federal government. It is occasionally called Traditional Medicare or Fee-for-Service (FFS) Medicare. Under Original Medicare, the government pays straight for the health treatment services you receive. You can see any physician and hospital that takes Medicare (and many do) throughout the nation.
In Original Medicare:
You go directly to the medical professional or medical facility when you need treatment. You do not need to get previous permission/authorization from Medicare or your primary care doctor.
You are responsible for a month-to-month premium for Part B. Some also pay a premium for Part A.
You usually pay coinsurance for every treatment you get.
There are limits on the amounts that medical professionals, as well as medical facilities, can bill for your care.
If you want prescription medication coverage with Original Medicare, most of the time, you will require to proactively select and also join a stand-alone Medicare Prescription Drug Plan (PDP).
Keep in mind: Some government plans may assist in lowering your healthcare and prescription drug expenses if you meet the eligibility requirements.
Unless you pick otherwise, you will have Original Medicare. Rather Than Original Medicare, you can decide to get your Medicare benefit from a Medicare Advantage Plan, likewise called Part C or private health insurance covered by Medicare. Keep in mind, you still have Medicare if you sign up for a Medicare Advantage Plan. This indicates that you should still pay your monthly Part B premium (and your Part A costs if you have one). Each Medicare Advantage Plan must provide all Part A and Part B services covered by Original Medicare. However, they can do so with different regulations, prices, and restrictions that can impact exactly how and when you get care.
It is necessary to understand your Medicare coverage options and to pick your coverage precisely. Just how you choose to receive your benefits and get them can influence your out-of-pocket expenses and where you can obtain your care. For instance, in Original Medicare, you are covered to visit almost all doctors and healthcare facilities in the nation. On the other hand, Medicare Advantage Plans usually have network restrictions, indicating that you will likely be a lot more restricted in your selection of medical professionals and medical facilities. Nevertheless, Medicare Advantage Plans can additionally give supplemental benefits that Original Medicare does not cover, such as regular vision or oral care.