Medicare Parts A and B and How They Work

Medicare Parts A and B and How They Work

Medicare Parts A and B: Coverage and Enrollment

Parts A and B are the most widely used portion of Medicare. Here’s how they work.

Now that you’re retired and looking forward to your golden years, you need to make sure you’re adequately covered for your medical expenses. For most people 65 and older, this means signing up for Medicare. Medicare is the federal health insurance program that covers senior citizens, along with:

  • ALS patients
  • People with permanent kidney failure
  • People with certain disabilities

Medicare has four parts, but Parts A and B are the most widely used. Together, they can help lower your medical costs a great deal. There are certain things they don’t pay for, though, such as prescription drug costs and various treatments. But you can get additional coverage through Medicare Parts C and D.

Medicare Part A

Part A covers basic hospitalization insurance. When you have to be in the hospital, it pays for your room and certain treatments, though not everything. You will have certain deductibles and copayments to meet as well. In general, though, Part A pays for:

  • In-patient hospital stays
  • Medically necessary home care for homebound patients
  • Hospice care for the terminally ill
  • Stays in a skilled nursing facility following hospitalization (but not long-term care)

Most people don’t have to pay a premium for Part A. If you or your spouse paid into Social Security for at least 10 years or 40 quarters, you won’t have to either. If you do not have enough quarters and are a U.S. citizen or are in the country legally for at least five years, you can still buy it and pay a monthly premium. But it could be expensive. Depending on the circumstances, it could cost more than $400 a month.

You should sign up for Medicare about three months before your 65th birthday. Remember that while the retirement age to get full Social Security benefits has changed, the age at which Medicare starts stayed at 65.

Medicare Part B

Part B is the government’s basic health insurance program for retirees. It gives you coverage for a wide range of outpatient care. This includes:

  • Doctor’s services
  • X-rays and lab tests
  • Flu vaccines
  • Kidney dialysis
  • Blood transfusions
  • Outpatient surgery
  • Cardiovascular screenings
  • Diabetes testing and education
  • Emergency room services
  • Outpatient mental health care
  • Mobility aids, such as canes and wheelchairs

These are the major items, but the list goes on. Part B also comes with premiums, copayments and deductibles that change from year to year. You’ll need to take these into account during financial planning.

Enrollment

For most people, signing up is painless. Three months before your 65th birthday, Medicare will automatically mail you a membership card. If you qualify for Medicare because of an illness or disability, though, the process will be different. Check with Social Security to find out.

Once you get the membership card, it’s yours to sign and keep. You can start using it right away. You also get a short enrollment form to fill out and send back. Make sure to do that by your enrollment deadline.

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