Medicare is one of the largest social health insurance systems in the world and belongs to the USA. It consists of a population of above sixty years of age. Also, other persons with a particular disability. There is need to have good information about Medicare plans for the citizens of Houston. In this guide, you will get acquainted with different components of Medicare plans. Which will assist you in making a right choice regarding health insurance. 

Medicare Plans Part A 

First component of Medicare is popularly referred to as Hospital insurance. It is applicable in covering the costs of inpatient which comprises hospital stays, nursing facilities, and some home health services. 

What Does It Cover?  

Medicare Part A aims to cover Hospital and Residential nursing home care. Part A also helps you to pay for being in a hospital if you’re counted as an inpatient. It also covers only some degree of days in the skilled nursing facilities (SNFs) in the case, they need rehabilitation or nursing after being admitted to the hospital. Further, Part A embraces hospice for the terminally ill and certain HH services, including part-time skilled nursing and therapy. 

Eligibility And Costs 

Many people also join Part A without applying if they are over 65 years and have paid Medicare tax for at least 10 years. If you or your spouse is sixty-five years of age or older, and you are a citizen welded with the United States or have a permanent resident status, you don’t have to pay this monthly premium to become qualified.  

But in other cases if you do not pay a monthly premium at a particular plan, then the cost of treatment personalized for you will be inclusive of the deductible and co-insurance.  

How To Enroll 

Part A can be taken at the first instance when you are qualified for Medicare. That is when you are 65 years old. You have an opportunity to apply online or in the Social Security Administration office. If you continue to work beyond age 65, you may not need to sign up for Part A immediately if your employer provides you with health coverage. 

Medicare Part B 

Medicare Part B helps to pay for the care that one gets on an outpatient basis. It requires attendance on physicians, preventive care, some outpatient procedures and operations and visits to purchase certain medical equipment. Part B is crucial as it keeps you healthy by offering check-ups other than being admitted to the hospital or hospital treatments. 

What Does Part B Of Medicare Cover? 

Out-patient services, which comprise annual check-ups or Physical examinations, and treatment by specialists. Such as physicians’ services, outpatient, diagnostic and therapeutic procedures, PT, OT, and many more come under Part B. It also encompasses such products as wheelchairs, walkers and other durable medical equipment (DME). You can also check with your Medicare agent for a better understanding.  

Eligibility And Costs 

Part B is usually paid with an extra monthly premium. The charges depend on your income level. About Part B related to your income, if your income is over a certain amount, you may choose to pay a larger premium for Part B. Part B, however, has an annual deductible that you have to pay before the coverage of your medical expenses is initiated. You will then typically be responsible for 20% of the Medicare allowed amount for most covered services after meeting the deductible. 

How to Enroll 

You can only enroll in Part B voluntarily during the Initial Enrollment Period or IEP when you first qualify for Medicare. If you miss the IEP, you can sign up during the GEP or during a SEP if you are eligible for it. However, if you have employer insurance, you can also postpone the enrollment for Part B without being penalized. 

Medicare Part C 

Medicare Part C is also known as Medicare Advantage plans. This is usually provided by private insurance companies accredited by Medicare authorities. They generally comprise extra benefits which are not covered under Medicare parts ‘A & B’ like vision, dental and prescription drug Plans and Costs of Medicare. 

What Part C Of Medicare Includes? 

This is the combining of Part A and B, with enhanced coverage in that it covers prescription drug saving commonly addressed as Part D and other services, including dental, hearing and vision care. Beyond these, Medicare Advantage plans provide extra opportunities for wellness benefits such as gyms so that you would be able to dedicate time to getting a healthier lifestyle. 

Consequently, arguably, the largest strength of Part C is the flexibility one has when selecting a plan. The common types of Medicare Advantage plan include Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Special Needs Plans SNPs. Every plan type has separate networks of doctors and hospitals that depend upon Medicare broker.  

Eligibility And Costs 

This plan can only be accessed by anyone already a member of Part A and Part B of Medicare. The details of Part C have different costs based on the plan one selects. Some Medicare Advantage plans require no additional cost over and above Part B, while others may attract a premium. It also expands to other directly attributable costs. That included other costs which you will be expected to pay from your pocket like co-payment, co-insurance and deductibles. 

How To Enroll 

You can join a Medicare Advantage plan at any other time of the year throughout the AEP, which is between October and December. You can also subscribe during your Initial enrollment period or during a SEP if you fall under the required conditions. 

Medicare Part D 

Medicare Part D is mainly drug coverage. This is part of Medicare because it is important to address some of the major costs that increase with age like the cost of taking medication. 

What Can Medicare Part D Pay For? 

Part D assists in paying for both the brand and the generic drugs. The coverage varies depending on the Part D plan you are in. Part D plans include prescription vaccines such as the shingles vaccine and prescription drugs offered for long-term management of illnesses such as diabetes and heart diseases. 

Eligibility And Costs 

Part D is available for anyone who is already enrolled in Part A or Part B In Part D. Also one has to pay for a monthly premium depending on their chosen plan. Like every other part of the Medicare program, individuals are required to meet an annual limit before they are required to pay for medicines.  

How To Enroll 

If you have Medicare Part C along with prescription coverage, you do not need a Part D plan; if you don’t understand, just read it as a Medicare Advantage Plan. But if your Medicare Advantage plan has no drug coverage, then you’ll need to sign up for a Part D plan. 

How to Select Medicare Plans 

There are a few different options for Medicare plans. Think about what your current healthcare needs are. If you take prescription medications, and if you want extra benefits in addition to Medicare. You should also compare the premiums, deductible and out pocket expenses of the assorted health plans. 

Consulting a Medicare broker will assist one in understanding these choices. A broker has a chance to offer you recommendations, which medication you should buy and the sums of money you should spend for this. 

Conclusion 

Medicare is an important program. It aims to offer health insurance to people who are aged and disabled persons. The distinction between the four components of Medicare plans: A, B, C, and D is vital for deciding on a particular program. Medicare can be confusing. Especially for those who are enrolling in it for the first time. But keep in mind, if you are willing to spend time comparing your options you will be able to get the right plan.