Understanding Medicare plans

How Medicare works and what are your options

When you turn 65, you are eligible to enroll in original Medicare. And while that sounds simple, weighing your Medicare options can be confusing. You are asked if you want to sign up for Part A and Part B – and if you want to enroll in options like Part C and Part D. It's hard to keep the options straight as you try to find what is best for you and your needs.

To help simplify things, we've outlined the basics to help you decide what's right for you. You can also RSVP to one of our educational Medicare 101 workshops to learn more.

Parts of Medicare

There are four parts of Medicare that make up your Medicare options:

Part A

Part A of original Medicare is offered through the federal government and helps pay for hospital expenses. For example, Part A helps cover your inpatient care in hospitals, or nursing facilities, including critical-access hospitals and long-term care hospitals. Most people automatically get Part A without having to pay a monthly premium.

Part B

Part B helps cover medical services like doctors’ services and outpatient care when they are medically necessary. You pay a monthly premium for Part B. If you don't sign up for Part B during your Initial Enrollment Period, you may pay a permanent late-enrollment penalty for every year that you delay. Visit medicare.gov for details.

Part C

Part C coverage is provided by Medicare Advantage (MA) plans and includes Part A and Part B coverage, as well as extra benefits. For some plans, you pay a monthly premium.

Part D

Part D coverage is designed to help lower your prescription drug costs. Part D coverage is available separately or may be included with an MA plan (Part C). If you do not enroll in Part D prescription coverage when you first become eligible for Medicare, you may have to pay a late enrollment penalty. The cost of the penalty depends on how long you went without Part D or creditable prescription drug coverage.

Watch our Basics of Medicare video below for more information on the parts of Medicare.

Your Medicare plan options

Here's how the different parts of Medicare come together.

Original Medicare plan

Original Medicare combines Part A and Part B and is offered to you through the federal government. Original Medicare only covers about 80% of your medical and hospital expenses. You are responsible for paying the other 20% – and 100% of your prescription drug costs.

Original Medicare doesn’t include a limit on your out-of-pocket expenses, so it’s difficult to predict your healthcare costs will be. It also doesn’t include Part D prescription drug coverage, so you’ll have to buy a separate plan that covers prescription drugs.

Medicare Advantage (MA) plan

When you join an MA (Part C) plan, you are still in Medicare, but you won’t have to use your Medicare card to get services. Your MA plan will provide Part A (hospital) and Part B (medical) coverage and other medically necessary services, as well as additional benefits that original Medicare doesn’t offer. Many MA plans also include Part D prescription drug coverage.

Plus, with an MA plan, all your healthcare ID cards are combined into one so that you don’t need to carry multiple cards with you. You’ll only need your Blue Cross of Idaho member ID card for all your medical services and for filling your prescriptions, if you have Part D included in your plan.

Here are a few things to remember about MA plans:

• Health plans offered by private insurance companies are approved by Medicare.
• Private plans provide Part A and Part B coverage, plus extras.
• You must continue to pay Part B premium, plus the private plan’s monthly premium, but MA premiums are generally lower than what you might pay for Medicare.

Browse our MA plan options to see which of our plans may work for you.

Medicare Supplement plan

Medicare Supplement plans work with original Medicare to fill the gaps not covered by Medicare alone. These plans do not include prescription drug coverage. For prescription drug coverage, you must buy a separate Medicare Part D drug plan.

Learn more about Medicare

We are hosting a series on educational Medicare events throughout Idaho. Select here to RSVP to an event near you.

You can also visit medicare.bcidaho.com for more information and frequently asked questions or download our Medicare for Idaho booklet.

 

Posted: May 12, 2022

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