Medicare Part A and Part B is the insurance program offered by the federal government.
Sometimes referred to as "Original Medicare," Medicare Part A and Part B provides eligible individuals with coverage at the hospital and doctor’s office. To be eligible, you must be 65 years of age or older, or you may also qualify if you are under 65 and have a disability. You can enroll in Medicare Part A and Part B through the government or by visiting Ssa.gov, which is the federal government’s social security website.
Medicare Part A and Part B benefits are comprised of two parts: 1) Medicare Part A, which is for hospital coverage, and 2) Medicare Part B, which includes doctor visits, mental health services, and ambulance services, among other kinds of coverage.
Medicare Part A covers inpatient hospital care, limited home health services, limited skilled nursing care facility services, and hospice care.
Inpatient hospital care includes coverage for a room, nursing services, medications, medical supplies, and meals that are necessary for your treatment. You can receive inpatient hospital care at the following types of facilities:
If your doctor has ordered home health care, and it is medically necessary, the following expenses should be covered by Medicare Part A:
You will not be covered for 24-hour home health care unless it is medically necessary.
If your doctor recommends you transfer from inpatient hospital care to a Medicare-certified skilled nursing facility, Medicare Part A should cover the following expenses:
Long-term medical or personal care is not covered if that is the only type of care you need.
If you have been diagnosed with a terminal illness, you may be eligible for hospice care, which will usually be provided in your home. To be eligible you must be (1) enrolled in Medicare Part A, (2) have been diagnosed by a doctor with a terminal illness with six months or less to live, and (3) agree to no longer receive medical treatment for your terminal illness.
You have the right to discontinue hospice care if you decide to seek additional treatment for a terminal illness at any time.
Medicare Part B covers visits to your doctor, preventative health screenings, blood tests, medical equipment and supplies, outpatient hospital care, and more.
You will pay a monthly premium for Part B benefits, as well as a small annual deductible and coinsurance (usually 20%).
Medicare Part B monthly premiums are based on income. Generally speaking, the higher your income, the higher your premium. The income tiers are as follows:
Beneficiaries who file individual tax returns with modified adjusted gross income: |
Beneficiaries who file joint tax returns with modified adjusted gross income: |
Income-Related Monthly Adjustment Amount |
Total Monthly Premium Amount |
---|---|---|---|
Less than or equal to $97,000 |
Less than or equal to $194,000 |
$0.00 |
$164.90 |
Greater than $97,000 and less than or equal to $123,000 |
Greater than $194,000 and less than or equal to $246,000 |
$65.90 |
$230.80 |
Greater than $123,000 and less than or equal to $153,000 |
Greater than $246,000 and less than or equal to $306,000 |
$164.80 |
$329.70 |
Greater than $153,000 and less than or equal to $183,000 |
Greater than $306,000 and less than or equal to $366,000 |
$263.70 |
$428.60 |
Greater than $183,000 and less than $500,000 |
Greater than $366,000 and less than $750,000 |
$362.60 |
$527.50 |
Greater than or equal to $500,000 |
Greater than or equal to $750,000 |
$395.60 |
$560.50 |
Please note that if you are already receiving Social Security or Railroad Retirement Board benefits, your monthly premium will automatically be deducted from these payments once you are enrolled in Medicare Part A and Medicare Part B.
Due to the lack of maximum out-of-pocket limits as well as the Part B coinsurance, many people seek to close the "gap" in Medicare Part A and Part B coverage with Private Medicare Insurance.
To cover the items that Medicare Part A and Part B does not cover, in addition to getting help for out-of-pocket costs, many people opt to purchase a Medigap, Medicare Advantage, or a Part D plan.
To get additional Medicare coverage, please submit your zip code to begin the process. You can also call (833) 596-1919 TTY users 711 Mon - Fri: 5am - 7pm, Sat - Sun: 5am - 8pm PT to speak with a licensed insurance agent.