Medicare AEP is a busy time for Empower Brokerage agents, but new brokers or those not in the Medicare space may have a hard time keeping up with all the parts that Medicare consists of. Below, you’ll find a brief breakdown of the four basic Medicare plans, Parts A through D. Clients can also purchase Medicare Supplement plans, not listed here, which are also named alphabetically from A to N.
Part A: Inpatient Coverage
Medicare Part A is part of Original Medicare and covers inpatient services, including for inpatient hospital, skilled nursing facility (SNF), home health, and hospice care. Part A covers up to 90 days per year in the hospital, plus an additional 60 days over the policy’s lifetime. In addition, Medicare covers up to 190 lifetime days in a psychiatric facility that has been pre-approved by Medicare. Part A also provides 100 days of SNF and home health care per benefit year if various diagnostic criteria are met. Both Parts A and B come directly from the government.
Part B: Outpatient Coverage
Medicare Part B is also part of Original Medicare but covers outpatient medical care like doctor’s office visits, durable medical equipment (DME), home health services, preventative care, therapy sessions, mental health services, lab tests, and chiropractic care. Part B may also cover some prescription drugs administered directly by a physician. Beneficiaries must pay a monthly premium for Part B, but Parts A and B both come directly from the government.
Part C: Medicare Advantage
Medicare Part C, also known as Medicare Advantage, is not a plan that beneficiaries can add to their existing Medicare coverage, but rather, an alternative to Original Medicare that includes the benefits of Medicare Parts A and B, plus additional coverage. Though Medicare Advantage plans offer the same benefits as Parts A and B, they may have different rules, costs, and restrictions than the original plans. Those with Medicare Advantage plans pay a monthly premium on top of their Part B premium since Medicare Advantage plans are provided through a private carrier.
Part D: Prescription Medications
Medicare Part D, or Medicare Prescription Drug Plans (PDP), covers medications that are not covered in parts A or B. Part D is only available through private insurance companies that have contracts with the government. Each plan covers different prescription medications, and the comprehensive list of drugs covered is called a formulary.
Additionally, Medicare Supplements, also called Medigap plans, can be purchased to cover a wider array of benefits like dental and vision services, but only by those on Original Medicare.
We hope this information on the four basic Medicare plans is helpful to you.
Empower Brokerage is dedicated to helping you educate your clients on the insurance they need and staying on top of their health. Whether it’s through webinar training, one-on-one calls, seminars, or marketing plans. We want you to be successful. Give us a call if you have any questions at 888-539-1633.
Originally from the snow-capped Rockies, Macee moved to Texas in 2016 to pursue an undergraduate degree in Strategic Communication. She currently serves as a writer and editor for Empower Brokerage, as well as the marketing manager for Preferred Senior Advisors. Macee is also working on her Master’s degree in management, and hopes to inspire others with her passion for telling stories through varied digital and print marketing efforts.