The basic parts of Medicare
You have options when it comes to selecting your Medicare coverage
Arkansas Blue Medicare is here to help you learn the facts and choose the right plan for you.
Let's start with exploring the basic Medicare parts.
The parts of Medicare
What is Medicare Part A?
Medicare Part A is one part of Original Medicare, which is administered by the federal government. It covers hospital and emergency care only.
What does Medicare Part A cover?
- Hospital stays (semi-private rooms) up to 60 days
- Nursing services
- Drugs, medical supplies and equipment used on the premises
- Part-time home nursing care
- Hospital meals
- Intensive care services, surgery and recovery costs
- Lab tests and X-rays taken while hospitalized
- Rehabilitation and therapy services
What isn't covered by Medicare Part A?
- Doctors and specialists who care for you in the hospital (this falls under Medicare Part B)
- Hospital stays longer than 60 days
- The cost of blood, if the hospital has to buy it for you
What is Medicare Part B?
Medicare Part B is the other part of Original Medicare, which is administered by the federal government. It covers physician services by any doctor in the country who accepts Medicare.
What does Medicare Part B cover?
- Doctor visits, lab and diagnostic tests
- Annual wellness exams and health screenings
- Medical equipment
- Mental health care
- Ambulance services
- Essential vaccinations, like the flu vaccine
Medicare limits how much you can be charged if you visit a covered provider. It does not limit how much you can be charged if you visit providers who opt out of Medicare. With Part B, you can see a specialist without prior authorization.
What isn't covered by Medicare Part B?
Medicare Parts A & B cover many doctor services and hospital costs, but they don't cover everything. Here are some of the things not covered by Parts A & B.
- Prescription drugs
- Routine eye exams, eyeglasses or contacts
- Hearing aids or related exams and services
- Non-emergency care while traveling outside the U.S.
- Chiropractic, acupuncture or related services
- Routine foot care
- Long term care
If you don’t have additional insurance that covers these services, you will have to pay the full cost. If these services are key to your health care, Part C Medicare Advantage plans may help.
What is Medicare Part C?
Medicare Part C is Medicare Advantage, which is provided by private insurance companies. You still enroll in Original Medicare Parts A & B, but you will receive all your government benefits, and in many cases additional benefits, through your insurer. Costs are specific to each plan and may vary.
What does Medicare Part C cover?
- All Part A & B benefits
- Most plans include prescription drug benefits
- Many plans offer additional benefits
Benefits that May Be Available with Medicare Advantage Plans
Comprehensive dental
Vision
Hearing aids
Fitness programs
Member rewards programs
The Different Types of Medicare Advantage Plans
HMO Plans
- Usually only cover care you receive from providers in the plan’s network
- Your care is coordinated by a primary care provider
- May require you to get a referral to see specialists or other providers
- You may have to pay for the entire cost of care received from out-of-network providers
PPO Plans
- Cover care received from both in- and out-of-network providers
- Pay a portion of charges for care you receive out-of-network
- Usually allow you to see a specialist without a referral
- You may pay more for care received from out-of-network providers
What is Medicare Part D?
Medicare Part D plans are prescription drug plans provided by insurance companies. Since prescription drugs aren’t covered by Original Medicare or Medicare Supplement plans, you can add a Part D plan to help you pay for your medications.
Ways to get Rx coverage
- A
- B
- D
- Supplement
- A
- B
- D
What is Medicare Supplement?
Medicare Supplement plans are provided by private insurance companies and help pay some of the out-of-pocket healthcare costs that Original Medicare (Parts A & B) doesn’t pay.
What Medicare Supplement Plans Cover
- Many Part A & B coinsurance, copays and deductibles
- Hospital stays beyond those covered by Part A
- Some preventive care services
- Blood transfusions
- Medical coverage anywhere in the U.S.
What Medicare Supplement Plans Don’t Cover
- Prescription drugs, so you may need to consider adding a Part D plan to your coverage.
How Do Medicare Supplement Plans Work?
What does it all cost
All Medicare plans have some level of cost sharing. Understand some of the costs you might be responsible for paying.
Learn about the costs of MedicareEligibility and enrollment
It's important to understand when you are eligible for Medicare, how to enroll and what to do if you are working past 65.
Learn more about eligibility and enrollmentChoosing your plan
There is no "one size fits all" to Medicare plans. Explore what you should consider when selecting your coverage.
Learn more about choosing your planY0083_2023AEP_Webpages_ABM_HA_M CMS Approved
Last updated 10/01/2022