Yes, I know, Medicare, a topic younger people think is irrelevant. However, learning about Medicare is important for those who qualify for it as well as the younger generation, simply because the younger generation, perhaps decades away from needing it, should still understand their parents’ medical care.
Most Americans know that Medicare is the United States federal health insurance program primarily for senior citizens; but if asked, those same people would probably admit confusion or frustration when it comes to understanding all the associated parts.
Medicare can be like a giant jigsaw puzzle, but once you see how the pieces fit together, it’s easier to see the big picture. Medicare has several parts, each with its own rules and costs. That’s where it can be a little tricky.
Part A (Hospital Insurance): This covers inpatient care in hospitals, skilled nursing facilities, and limited home health care. It’s generally free if you’ve worked and paid into Medicare for at least 10 years. However, if you need to stay in a hospital for a while, get ready for some out-of-pocket costs, like deductibles and coinsurance.
Part B (Medical Insurance): This covers things like doctor visits, outpatient care, and preventive services. Unlike Part A, you do have to pay a monthly premium for Part B. It usually starts around $164.90 per month in 2025, but it can go up based on your income. Here’s where things can start to get a little confusing. There are deductibles and copays on top of the monthly premium, and it doesn't cover everything—like most dental, vision, and hearing care.
Part C (Medicare Supplement): This is like a bundle deal where private insurance companies take over your Medicare benefits (including Parts A and B) and sometimes even Part D (the drug coverage). They often offer extra benefits (like dental, vision, hearing) but can come with higher premiums, rules, and network restrictions. It’s a way to get more coverage, but you have to pay attention to which doctors and hospitals are covered.
Part D (Prescription Drug Coverage): If you don’t have Part C, you can get Part D to cover prescription drugs, but not all Part D plans are the same. Some cover more meds, and others might have more affordable copays. The plan you pick can affect how much you’ll pay.
If that didn’t seem like enough puzzle pieces, there’s more! You’ll also have to navigate how to handle Medigap, or Medicare Supplement Insurance, which helps pay the costs that Original Medicare (Parts A and B) does not cover, like copays, coinsurance, and deductibles. There’s an open enrollment period for this, if you miss it, you might get hit with penalties. You may be subject to medical underwriting instead of guaranteed issue or you might not be able to get the plan you want.
The complexity of this puzzle comes from balancing premiums, copays, rules, networks, and deadlines, all while figuring out whether you need additional coverage (like Medigap or a Medicare supplement insurance plan) and how to keep track of costs. It can start to feel like the small four part puzzle has grown to a 250 piece puzzle.
Don’t let the complicated intricacies overwhelm you. Sometimes a second set of eyes and ears can be useful in helping to find the right pieces to complete your own personal picture. As always, we are here to help; give us a call and we can help you sort through all the pieces.
If you would like a copy of our Medicare Special Report email us at peaceofmind@yieldins.com
Image 1 by congerdesign
Image 2 by Marjon Besteman
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