What Is Medicare
Who it's for
What does it cost
what it covers
Medicare is the federal health insurance program for:
- People who are 65 years of age or older
- Those who are disabled on SSDI for 24 months or more
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
what it covers
What does it cost
what it covers
The different parts of Medicare help cover specific services:
- Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. - Medicare Part B (Medical Insurance)
Part B covers certain doctors' services, outpatient care, medical supplies, and preventiv
The different parts of Medicare help cover specific services:
- Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. - Medicare Part B (Medical Insurance)
Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. - Medicare Part D (prescription drug coverage)
Helps cover the cost of prescription drugs (including many recommended shots or vaccines).
What does it cost
What does it cost
What does it cost
You usually don't pay a monthly premium for Part A if you or your spouse paid Medicare taxes while working for a certain amount of time. (40 quarters or 10 years) This is sometimes called "premium-free Part A."
If you aren't eligible for premium-free Part A, you may be able to buy Part A. You'll pay up to $505 each month in 2024. If you p
You usually don't pay a monthly premium for Part A if you or your spouse paid Medicare taxes while working for a certain amount of time. (40 quarters or 10 years) This is sometimes called "premium-free Part A."
If you aren't eligible for premium-free Part A, you may be able to buy Part A. You'll pay up to $505 each month in 2024. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $505. If you paid Medicare taxes for 30–39 quarters, the standard Part A premium is $278.
Most people will pay the standard Part B premium amount which in 2024 is $174.70. If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you'll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.
How You Are Covered By Medicare
Original Medicare (Part A & B)
Original Medicare (Part A & B)
Original Medicare (Part A & B)
These are your cost share responsibilities with original Medicare.
Part A
(Hospital)
2024
Monthly Premium
$0.00 - $505.00
Inpatient Hospital Deductible (Days 1-60)
$1,632
Daily Hospital Coinsurance for 61st-90th Day $408 Per Day
Daily Hospital Coinsurance for Lifetime Reserve Days (After 90 Days)
$816 Per Day
No Coverage After Lifetime Reserve Day
These are your cost share responsibilities with original Medicare.
Part A
(Hospital)
2024
Monthly Premium
$0.00 - $505.00
Inpatient Hospital Deductible (Days 1-60)
$1,632
Daily Hospital Coinsurance for 61st-90th Day $408 Per Day
Daily Hospital Coinsurance for Lifetime Reserve Days (After 90 Days)
$816 Per Day
No Coverage After Lifetime Reserve Days Are Exhausted
Skilled Nursing Facility Daily Coinsurance (days 21-100)
$204.00
Mental Health
20%
Part B
(Medical)
2024
Monthly Premium
$174.70 - $594.00
Annual Deductible
$240
After Deductible
20% With No Max Out Of Pocket
What it helps cover:
- Medically Necessary Doctors' Services
- Outpatient Care
- Medically Necessary Chiropractic Care
- Home Health Services
- Durable Medical Equipment (DME)
- Preventative Services
Does Not Cover Prescription Drugs
(See Part D)
Drug Coverage (Part D)
Original Medicare (Part A & B)
Original Medicare (Part A & B)
Medicare Part D helps cover prescriptions drugs and is offered through private insurance companies contracted by the federal government.
Plan monthly premiums and the drugs they cover will vary.
Deductibles, coinsurance and copays will vary from plan to plan as well.
So you should check and compare plans each year based on your needs, the
Medicare Part D helps cover prescriptions drugs and is offered through private insurance companies contracted by the federal government.
Plan monthly premiums and the drugs they cover will vary.
Deductibles, coinsurance and copays will vary from plan to plan as well.
So you should check and compare plans each year based on your needs, the prescription drugs you take, etc.
You can obtain coverage through a standalone Prescription Drug Plan (PDP) or with a Medicare Advantage plan with a Prescription Drug plan included (MAPD).
Which one you choose is specific to your situation and how you obtain your coverage.
What it costs:
Plans vary in monthly cost, coverage, deductibles and copays.
Late Enrollment Penalty
There’s a Part D late-enrollment penalty if you don’t enroll in an approved Medicare drug plan (including a Medicare Advantage plan) when you’re first eligible, unless you have other creditable prescriptions drug coverage.
Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($34.70 in 2024) times the number of full, uncovered months you didn't have Part D or creditable coverage. This penalty is assessed when you enroll in a part D plan, and you’ll pay the higher amount for as long as you keep your Part D coverage.
Your Part D premium could be higher depending on your income level.
Medicare Advantage (ParT C)
Original Medicare (Part A & B)
Medicare Advantage (ParT C)
What it helps cover:
Medicare Advantage plans are required by law to provide—at minimum—the same coverage, benefits and rights provided by Original Medicare Part A and Part B.
Many Medicare Advantage plans also include prescription drug coverage at no additional cost.
There are several plans which include non-Medicare covered benefits such
What it helps cover:
Medicare Advantage plans are required by law to provide—at minimum—the same coverage, benefits and rights provided by Original Medicare Part A and Part B.
Many Medicare Advantage plans also include prescription drug coverage at no additional cost.
There are several plans which include non-Medicare covered benefits such as routine dental, vision, hearing as well as over the counter allowance and or flexible spending card to minimize your out of pocket costs for your everyday needs.
Medicare Advantage plans provide Medicare coverage through private health insurance companies approved to participate in the Medicare program. These plans can be HMOs, PPOs, Regional PPOs or Private Fee-for-Service plans.
These plans also tend to have lower cost sharing overall and a maximum that you would have to pay for out-of-pocket costs each calendar year, a feature not available through Original Medicare.
What it costs:
Medicare Advantage plans are offered by private insurance companies contracted by the federal government, so they vary in cost, coverage, deductibles and copays. All benefits and plans are subject to annual changes.
Many Medicare Advantage plans offer affordable or zero dollar premiums.