Medicare confuses me. What do those letters mean?

Posted: August 12, 2016, 8:08AM

Medicare coverage can entail four parts and each is identified by a letter. AARP's March Bulletin explained this very well!

* PART A helps pay for stays in hospitals and skilled nursing facilities, home health services and hospice care as long as certain criteria are met. You don't pay for Part A Medicare as long as you (or your spouse if you collect on their Social Security) paid sufficient Medicare taxes while working. If not, you can buy Part A services by paying monthly premiums.

* PART B helps pay for doctors' services (in and out of the hospital) and outpatient care such as lab work and screenings. Part B will also pay toward some medical equipment and supplies, if criteria are met, and most drugs or vaccines administered in a doctor's office. You pay monthly premiums for Part B unless you qualify for an assistance program. Medicare generally covers 80% of reasonable and customary charges and you pay 20% unless you have a Medicare supplement that covers out-of-pocket expenses. There is a penalty for not enrolling in Part B when you are eligible.

* PART C provides an alternative to traditional Medicare coverage through Medicare Advantage which is administered through private managed care plans. These plans must cover the same services as traditional Medicare programs (Parts A & B) but may charge lower co-pays. Some plans offer Part D coverage, and some offer extra services such as routine dental, vision and hearing care. You may pay a monthly premium (in addition to the Part B premium). Medicare Advantage plans may restrict your choice of doctors and medical facilities or other providers, and/or charge higher co-pays for out-of-network providers. Medicare Advantage providers vary in different areas.

* PART D is the prescription drug "piece" of Medicare, helping pay for prescription drugs that you use at home. You can join a 'stand-alone' Part D drug plan for an additional monthly premium if you are in traditional Medicare or you can enroll in a Medicare Advantage plan that includes Part D coverage in its benefit package. There is a penalty if you do not enroll when you are eligible.

There are Medicare Savings Programs for those who have a limited income and who qualify for extra help. You can read more about these programs on the Medicare website.

You can learn more about Medicare by attending our MEDICARE BASICS program on September 22, 2016 with WV State SHIP director Marcia Meeks.

You can learn about specific Part D options by attending our MEDICARE OPEN ENROLLMENT INFORMATION programs on October 20 and/or November 15, 2016 with Citywide Insurance representative John Forsyth.

These programs are free and open to the public. Just give us a call at 304 243-0996, email me at akoegler@frontier.com or send us a message through our website.