Medicare

Medicare Part A

Medicare Part A is the portion of this program that pays for hospital, or inpatient, services. Covered services include inpatient hospital care, care at a skilled nursing facility, home health care, and hospice care. To receive these benefits, each person must meet certain eligibility qualifications. Most beneficiaries who receive coverage under Medicare Part A do not pay a premium, because the program is financed through payroll taxes that were deducted while beneficiaries were working. Part A is known as a fee-for-service benefit, whereby coverage is determined based on the services rendered by the health care provider.

Medicare Part B

The Medicare Part B program provides supplementary medical insurance to those electing to receive the benefit. There is a premium associated with this portion of the program, which is paid monthly by the beneficiary. Part B provides coverage for outpatient health services provided in local clinics or home health service organizations, as well as coverage for specific medical devices and equipment. Covered services include physician services, other outpatient care, drugs and biologicals, durable medical equipment, and preventive services (such as annual screenings). Services that are not covered by Part B include routine physicals, foot care, hearing aids or eyeglasses, dental care, and outpatient prescription drugs. Part B is also a fee-for-service program.

Medicare Advantage (Part C)

Formerly known as Medicare Part C or the Medicare + Choice program, Medicare Advantage is the Medicare program that allows beneficiaries to receive covered benefits through a private health plan. Specifically, if a person is enrolled in Medicare Advantage, there is no need to be enrolled in Medicare Parts A, B, or D. Medicare Advantage provides coverage of inpatient and outpatient services, in addition to prescription drug coverage, in one plan, which is administered by a variety of private health plans. Medicare Advantage is not a fee-for-service program.

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