24. Medicare Part D Coverage

medicare-part-dPrescription drug coverage is provided under Medicare Part D. It is issued by private insurers and is a policy you purchase separately. Plans will vary from insurer to insurer. Some have deductibles. Some do not. Once your deductible is met, the plan pays for some or all of your prescription drug costs up until an annual cost of $2,970. At that point you have reached the Medicare Donut Hole up until an annual cost of $4,750.

Previously, beneficiaries paid 100% of their costs inside the Donut Hole before Part D coverage kicked back in. Under Obamacare, participants now pay 52.5 percent of the cost for brand name drugs and 79 percent of the cost for generic drugs.

 

25. Medicare Part C Coverage

medicare-part-cMedicare Part C is also known as Medicare Advantage. These are private plans that are run through Medicare. Medicare requires that they be “equivalent” to Part A and Part B coverage. That equivalency does not mean they are identical in coverage to Part A and Part B. A Medicare Advantage plan may cover less of one thing but more of something else than what is covered under either Part A or B.

Some Medicare Advantage plans will provide you with significantly more coverage than anything provided by Part A and B, often including prescription drug coverage. In that way, they are similar to a Medicare Supplemental or Medigap plan. The difference between them though is that they are administered by Medicare rather than private insurance companies.

26. Medicare Part B Coverage

medicare-part-bDoctor visits, some outpatient costs like physical therap, and some medical equipment are covered by Medicare Part B. In addition, some preventative healthcare costs such as colon and prostrate screenings are covered, as well as diabetes testing.

27. Medicare Part A Coverage

medicare-part-aMedicare Part A covers you if you should find yourself hospitalized. If you have paid into the Social Security pool for at least 10 years, the coverage requires no premiums to be paid.  There are a few gaps in Part A that you can close with a Medicare supplement plan G or plan F policy.

28. Be Careful Not To Purchase Too Much Coverage

obamacareUnder the Affordable Care Act (Obamacare), beneficiaries are already entitled to annual exams and recommended preventative healthcare screenings without co-pays or deductibles. The drug coverage Medicare Donut Hole is also shrinking.

29. The Medicare Donut Hole

medicare drug coverageThe Medicare Donut Hole refers to out of pocket costs for beneficiaries on prescription drug coverage. Until 2010, beneficiaries were required to pay 100 percent of their annual drug costs between $2,700 and $4,350 each year. After $4350, their prescription coverage would kick in again. With Obamacare going into effect, in 2013 participants pay 52.5 percent of brand name medications and 79 percent of the cost of generic drugs. The donut hole now is between $2,970 and $4750.