Jason Fitzgerald Korb is an insurance broker serving the Maryland, Virginia, and Washington D.C. area. Ever since growing up in Brookline, Massachusetts and seeing his father on disability struggling to understand and make full use of his Medicare benefits, Jason has dedicated his practice to not only providing the best product for his clients but also ensuring they fully understand them as well. This article seeks to help with that effort.
Medicare is a federally administered health insurance program typically for those who are 65 years or older, those under 65 with disabilities, and those with End-Stage Renal Disease (ESRD).
Medicare has different parts that cover different services:
Medicare Part A – Is Your Hospital Insurance Part A will cover you when you are admitted inpatient in a hospital, a skilled nursing facility, hospice, and some home health services.
Medicare Part B – Is Your Medical Insurance Part B will cover you for certain services provided by a doctor, preventive services, medical supplies, and outpatient care.
Both Part A and B have deductibles and coinsurances. With Part A you have to meet the annual deductible, if you are admitted in a hospital facility from days 1-60 there is no coinsurance; after that there are fixed coinsurances for certain periods up to 150 days where you would be responsible for the full amount. Under Part B you must meet the annual deductible as well, and then after that you are then typically covered for 80% of your qualified expenses; you would have to pay the coinsurance for the other 20%. Having Original Medicare, which is just your Part A and B (your red, white and blue card), allows you to go to any provider that accepts Medicare in the United States; however, as stated above, you are responsible for the deductibles and the coinsurances of qualified services acquired; if not a qualified service, you may have to pay the full amount. Most preventative services are covered under Part B with no coinsurance to the beneficiary.
Part A and B do not cover prescription drugs, and therefore if you need prescription drug benefits you would have to purchase a separate prescription drug plan referred to as Medicare Part D. If you enroll in a plan that covers prescription drugs, you do not and in most circumstances cannot enroll in a separate prescription drug plan.
Medicare Part D – Prescription Drug Plans (PDP) Part D plans are purchased in addition to paying for your Medicare premiums unless you get Extra Help from Medicare or Medicaid to cover those costs. You may purchase a PDP or Part D plan if you are entitled to Part A and/or Part B. Part D plans are purchased from private insurance companies that are regulated by CMS. Premiums, deductibles, co-pays, co-insurances, and coverage limits may apply. Failure to select a Medicare Part D plan or have credible prescription coverage as determined by Medicare can result in an ongoing penalty when you do decide to enroll in a Medicare Part D plan.
Medicare is a federally administered health insurance program typically for those who are 65 years or older, those under 65 with disabilities, and those with End-Stage Renal Disease (ESRD).
Medicare has different parts that cover different services:
Medicare Part A – Is Your Hospital Insurance Part A will cover you when you are admitted inpatient in a hospital, a skilled nursing facility, hospice, and some home health services.
Medicare Part B – Is Your Medical Insurance Part B will cover you for certain services provided by a doctor, preventive services, medical supplies, and outpatient care.
Both Part A and B have deductibles and coinsurances. With Part A you have to meet the annual deductible, if you are admitted in a hospital facility from days 1-60 there is no coinsurance; after that there are fixed coinsurances for certain periods up to 150 days where you would be responsible for the full amount. Under Part B you must meet the annual deductible as well, and then after that you are then typically covered for 80% of your qualified expenses; you would have to pay the coinsurance for the other 20%. Having Original Medicare, which is just your Part A and B (your red, white and blue card), allows you to go to any provider that accepts Medicare in the United States; however, as stated above, you are responsible for the deductibles and the coinsurances of qualified services acquired; if not a qualified service, you may have to pay the full amount. Most preventative services are covered under Part B with no coinsurance to the beneficiary.
Part A and B do not cover prescription drugs, and therefore if you need prescription drug benefits you would have to purchase a separate prescription drug plan referred to as Medicare Part D. If you enroll in a plan that covers prescription drugs, you do not and in most circumstances cannot enroll in a separate prescription drug plan.
Medicare Part D – Prescription Drug Plans (PDP) Part D plans are purchased in addition to paying for your Medicare premiums unless you get Extra Help from Medicare or Medicaid to cover those costs. You may purchase a PDP or Part D plan if you are entitled to Part A and/or Part B. Part D plans are purchased from private insurance companies that are regulated by CMS. Premiums, deductibles, co-pays, co-insurances, and coverage limits may apply. Failure to select a Medicare Part D plan or have credible prescription coverage as determined by Medicare can result in an ongoing penalty when you do decide to enroll in a Medicare Part D plan.