Medicare coverage is divided into several different parts that cover certain medical needs, including prescription drugs. This federal health insurance program was implemented to ensure that citizens that meet the requirements have access to health insurance coverage, including seniors and individuals dealing with disabilities or certain illnesses. Reviewing each plan thoroughly can help you decide which ones you need to enroll in.

It is important to understand the Medicare cost associated with each specific plan, since it may vary based on different factors. Like most health insurance plans, coverage and fees may change from year to year. As such, a Medicare fee schedule is released each year that explains the current level of coverage offered and what you must pay out-of-pocket when seeking treatment. Read on to find out more about general costs and coverage associated with this federal health program.

Learn How to Calculate Your Medicare Costs

“How much does Medicare cost?” is an important question to ask before you seek coverage through this insurance program. It is important to thoroughly understand the financial responsibilities you may encounter, as this can vary based on several factors. Each year, you are offered different plans, which may be associated with different costs. Some of the most common costs you may be responsible for when using Medicare include:

• A monthly premium.
• An annual deductible.
• A copayment or coinsurance costs each time you seek treatment.

Medicare premiums are calculated based on the type of plan you choose, the parts involved and your own qualifications. In some cases, you may not owe a monthly premium for the coverage you choose. Whether or not you have this premium, you may also need to make a copayment each time you use your coverage for a doctor’s visit, prescription or other services. Your copayment amount varies by plan and may also depend on the type of treatment you are seeking.

Keep in mind, if you use medical service providers that are in your network, the out-of-pocket costs for Medicare coverage may be much less. If your preferred doctors or facilities are out of network, your costs will be higher for these services, even if they are covered under your plan.

Your Medicare deductible may also vary depending on the plan you choose. Your deductible is the money you must pay out-of-pocket for treatments before the insurance begins to take effect. This deductible generally resets each year, and any payments you make for treatments contribute to your deductible, including copays.

Discover the Medicare Coverage Basics

When calculating your Medicare costs, it is also important to understand the coverage your plan affords you. This largely depends on whether you select the Part A, Part B, Part C or Part D plan, or a combination of a few. Depending on the parts that are included in your specific plan, you may have coverage for:

• Hospital visits.
• Doctor’s appointments.
• Treatment through specialists.
• Prescription drugs.
• Preventative treatments.
• Home health care.

In some cases, you may decide to purchase an additional health insurance policy as well. This can allow you to access more coverage not addressed in your Medicare plan, or receive lower rates on some coverage. If you have an additional insurance policy, both of your plans are considered “payers.” These payers use strict coordination of benefit rules to figure out which plan is responsible for your medical costs each time you seek treatment.

The first plan to cover the expense is considered the “primary payer” and the remaining balance is sent to the “secondary payer.” Keep in mind that even if you have Medicare coverage and an additional health insurance plan, you may still be responsible for out-of-pocket costs like copayments and premiums. Both plans may also have their own deductibles you must meet as well. Therefore, you may still want to consider only using doctors and facilities that are in your network.

Since the Medicare fee schedule is recalculated each year, this can also affect the type of medical procedures that are covered under your plan. Therefore, reviewing the coverage and how it relates to your personal health when choosing a plan is just as important as comparing premiums and fees. To learn more about Medicare costs, download our complete guide to Medicare.

Learn About Medicare Coverage

Medicare coverage is organized into several different parts, and you can qualify for and enroll in each part, as needed. Each part of your insurance plan may be associated with different costs, including coinsurance or copayments and deductibles. Your Medicare premiums may also vary, depending on the parts of the program you choose to enroll in. The different parts of Medicare include the following:

• Part A. This part covers hospice care, home health care, and nursing facility care. Additionally, you may also have inpatient hospital care covered through this part of the plan.
• Part B. Services from doctors and other outpatient care is covered under this part of the plan. Necessary medical equipment, such as a wheelchair, or preventative services, such as a health screening, may also be covered under this specific part.
• Part D. This part of Medicare insurance is actually administered by private insurance companies that follow specific Medicare rules. It helps to cover the cost of prescription drugs.

When reviewing the parts of coverage for Medicare, you also have to consider Part C. This option is also commonly referred to as “Medicare Advantage,” because it combines Parts A, B and sometimes Part D to create a comprehensive policy. There may be benefits to choosing a bundled plan like Medicare Advantage, such as lower out-of-pocket costs for services.

When choosing the type of Medicare policy or policies you need, it is important to review the details of the coverage provided and what is included. Reviewing the doctors and facilities that are in the network for your specific plan is a helpful way to better understand if the policy works for you and your needs. By reviewing and comparing these Medicare coverages and the costs associated with your plan, you can decide which parts you need and what coverage is right for you. To learn more about the different parts of Medicare, download our comprehensive Medicare assistance guide.