Quickly decipher the oftenconfusing world of senior coverage

If you’re approaching retirement age, you’re likely hearing a lot about Medicare. The landmark program that provides hospital care, doctor visits and more to seniors in the United States can seem confusing and overwhelming, but luckily, four simple letters give an overview on the system and what it provides.

Medicare, like all health plans, has a sliding scale of cost depending on qualifications, though it is available in its basic form to all people over 65. Some patients will be signed up automatically, and others will go through an enrollment process similar to choosing a health plan. Everyone who navigates the process has questions, and the best place to learn more is medicare.gov, the official site. To get started, familiarity with Medicare’s four divisions is helpful.

Part A: An original part of the Medicare system when it was implemented in 1966, Medicare Part A is, at its core, hospital insurance. Typically, Part A pays for inpatient hospital visits, surgeries and related care for up to 60 days after a single deductible. Skilled nursing center stays as a part of rehabilitation can also be covered by Part A, if the rehab is related to a covered surgery or treatment.

In addition, Medicare Part A provides hospice care for patients. This coverage provides full coverage for pharmaceuticals for symptom control, grief counseling, and other services not normally provided by standard Medicare.

Part B: Like Part A, some people automatically get Medicare part B when they turn 65 or earlier, depending on eligibility or preexisting disability status. Part B is the section of Medicare that covers doctor’s visits, durable medical equipment (mobility devices, safety equipment, etc.) and other outpatient services like preventative medicine or x-rays.

Part B offers low copays and high coverage rates for continuing medical issues like dialysis or transfusion. The plan can also cover other basic services like lab tests and chiropractic services.

Part C: Medicare Part C, also known as Medicare Advantage, is typically well-known. That is because Part C is provided through insurance companies as a supplement to standard Medicare A and B services. Medicare Advantage plans meet or exceed the benefits and coverage levels laid out in original Medicare.

Some benefits to having a Medicare Advantage plan include lower copays and more perks, including expanded outpatient care, medical transportation, in-home supportive services, and even meal plans, exercise monitoring equipment, gym memberships, wellness instruction or hearing aids. Since Part C plans are provided by insurers, the best way to learn more is to visit individual websites for comprehensive lists of pricing and available benefits.

Part D: The newest addition to Medicare, Part D specifically covers prescription drugs and is available to anyone with Parts A and B. The plan covers a wide range of self-administered drugs, including generic and name-brand prescriptions.

This lowers costs for medications needed to treat long-term conditions or keep patients healthy. For those that qualify, the Extra Help program can be added to Part D to lower drug costs further.

If you have Medicare Advantage, then Part D is not needed, as prescription drug plans are included in Part C.

Regardless of the health coverage you choose, consult medicare.gov, your primary care provider, health insurance provider or coveredca.org to aid in picking the best plan for you. Person-to-person help is also available contact-free using telehealth or online during the COVID-19 pandemic.

— Alan LaGuardia
Custom Publishing Writer