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MEDICARE BASICS

If you are age 65 or older or on Social Security disability for over 24 months you are eligible for Medicare.

Medicare is most commonly broken into the following “parts”.

  • Part A | Hospital/Skilled Nursing Facility – Hospital stays have a $1364.00 (in 2019) deductible per benefit period, co-insurance for stays after 60 days. Skilled Nursing has qualifying requirements to meet to qualify for coverage, the first 20 days covered at $0 then a co-insurance for days 21-100, no coverage for days over 100. No premium in most cases. This is a Government provided and managed program.

  • Part B | Medical/Doctor Insurance – Has an annual $185 (in 2019) deductible with an 80/20 cost sharing after the deductible has been met. Premiums are $135.50 (in 2019) in most cases. Premiums are higher for incomes over $85,000 for individual or $170,000 for a married couple. This is a Government provided and managed program.

  • Part C | Medicare Advantage – Most plans have no deductibles. Copays and co-insurance with maximum out of pocket limits. Premiums average between $0 -$200 per month. Provided through private insurance companies. Provides Part A, B coverage along with Part D with most plans.

  • Part D I Prescription Drug Coverage - Original Medicare does not provide for prescription drug coverage. In order to get Medicare drug coverage, you must join a plan provided by a private insurance company

Many people find they need more coverage than what Medicare can offer by itself. They find gaps between what they need, what they want, and what is covered. If you find yourself in this situation, your Keystone agent can help you decide which Medicare Supplements best suit your needs or if you should move to a Medicare Advantage Plan.