Medicare Explained

What is Medicare?

Medicare is a federally tax-funded health insurance program for seniors ages 65 and up.

The word “coverage” will often appear when reading about Medicare. Coverage refers to the medical services, the costs for coinsurance, and copayments that Medicare pays.

MEDICARE PARTS

Medicare coverage is divided into subcategories called “Parts,” and each one is purchased separately. The Parts are A, B, C, and D. Each part has a different premium. Keep reading to learn more about how each part helps you cover your medical costs.

Medicare Part A covers inpatient services.
• Hospital Visits
• Overnight Admissions
• Patient Meals
• Hospice Care
• Skilled Nursing Facilities

Medicare Part B covers outpatient care or any medical treatments you would get outside of an emergency room, hospice center, or skilled nursing facility.

• Wellness Visits
• Medicare Part B coverage
• Chemotherapy
• X-rays
• Cancer screenings
• Lab tests

Medicare Part C, which is more often referred to as “Medicare Advantage,” is a combination of Medicare Parts A, B, and D.

Medicare Advantage is sold via private insurance. It features inpatient (Part A), outpatient (Part B), and prescription drug (Part D) coverage together.

Part D reduces prescription medication costs, but only for select medications in specific categories outlined in the “formulary.” The formulary must cover at least two medications in each of the six medication categories.
Part D categories are:

• Antidepressants
• Anticonvulsants
• Anticancer
• Immunosuppressants
• Medications for HIV/AIDS
• Antipsychotics

What Medicare Part D does NOT cover
• Benzodiazepines
• Barbiturates
• Medications taken for cosmetic reasons
• Flu medications