Medicare Advantage Plans or Medicare Supplement Plans?
Your Medicare coverage options
There are 2 main ways to get your Medicare coverage—Original Medicare and Medicare Advantage.
Choose the option you want to explore first. Don't worry, you can review both. Just start with either one.
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o Includes Hospital (Part A) and Medical (Part B) insurance.
o If you want drug coverage, you can add a separate Drug plan (Part D).
o You can also add a Medicare Supplement Insurance (Medigap) policy to help pay your out-of-pocket costs.
Original Medicare
o An all-in-one alternative to Original Medicare.
o These "bundled" plans include Part A, Part B, and usually Part D.
o Most plans offer extra benefits—like vision, hearing, dental, and more.
Medicare Advantage Plan
What Part A covers What's covered?
Note |
If you're in a Medicare Advantage Plan or other Medicare plan, your plan may have different rules. But, your plan must give you at least the same coverage as Original Medicare. Some services may only be covered in certain settings or for patients with certain conditions. |
In general, Part A covers:
2 ways to find out if Medicare covers what you need
Medicare coverage is based on 3 main factors
What Part B covers
Note |
If you're in a Medicare Advantage Plan or other Medicare plan, your plan may have different rules. But, your plan must give you at least the same coverage as Original Medicare. Some services may only be covered in certain settings or for patients with certain conditions. |
What's covered?
Part B covers 2 types of services
You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.
Part B covers things like:
Limited outpatient prescription drugs
2 ways to find out if Medicare covers what you need
Medicare coverage is based on 3 main factors
Medicare costs at a glance
Listed below are basic costs for people with Medicare. If you want to see and compare costs for specific health care plans, visit the Medicare Plan Finder.
For specific cost information (like whether you've met your deductible, how much you'll pay for an item or service you got, or the status of a claim), log into your secure Medicare account.
2021 costs at a glance |
|
Part A premium |
Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A"). If you buy Part A, you'll pay up to $471 each month in 2021. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $471. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $259. |
Part A hospital inpatient deductible and coinsurance |
You pay:
|
Part B premium |
The standard Part B premium amount is $148.50 (or higher depending on your income). |
Part B deductible and coinsurance |
$203. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment (dme) |
Part C premium |
The Part C monthly premium varies by plan. Compare costs for specific Part C plans. |
Part D premium |
The Part D monthly premium varies by plan (higher-income consumers may pay more). Compare costs for specific Part D plans. |
Part A costs
How much does Part A cost?
Premium-free Part A
You usually don't pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes for a certain amount of time while working. This is sometimes called "premium-free Part A."
Most people get premium-free Part A.
You can get premium-free Part A at 65 if:
If you're under 65, you can get premium-free Part A if:
Part A premiums
If you don't qualify for premium-free Part A, you can buy Part A.
People who buy Part A will pay a premium of either $252 or up to $458 each month in 2020 depending on how long they or their spouse worked and paid Medicare taxes. If you choose NOT to buy Part A, you can still buy Part B.
In most cases, if you choose to buy Part A, you must also:
Contact Social Security for more information about the Part A premium.
Learn how and when you can sign up for Part A.
Find out what you pay for Part A-covered services.
Part B costs
Some people automatically get Medicare Part B (Medical Insurance), and some people need to sign up for Part B. Learn how and when you can sign up for Part B.
If you don't sign up for Part B when you're first eligible, you may pay a late enrollment penalty.
How much does Part B cost?
Part B premiums
You pay a premium each month for Part B. Your Part B premium will be automatically deducted from your benefit payment if you get benefits from one of these:
If you don’t get these benefit payments, you’ll get a bill.
Most people will pay the standard premium amount. If your modified adjusted gross income is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago. This is the most recent tax return information provided to Social Security by the IRS.
The standard Part B premium amount in 2020 is $144.60. Most people pay the standard Part B premium amount. If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you'll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.
If your yearly income in 2018 (for what you pay in 2020) was |
You pay each month (in 2020) |
||
File individual tax return |
File joint tax return |
File married & separate tax return |
|
$87,000 or less |
$174,000 or less |
$87,000 or less |
$144.60 |
above $87,000 up to $109,000 |
above $174,000 up to $218,000 |
Not applicable |
$202.40 |
above $109,000 up to $136,000 |
above $218,000 up to $272,000 |
Not applicable |
$289.20 |
above $136,000 up to $163,000 |
above $272,000 up to $326,000 |
Not applicable |
$376.00 |
above $163,000 and less than $500,000 |
above $326,000 and less than $750,000 |
above $87,000 and less than $413,000 |
$462.70 |
$500,000 or above |
$750,000 and above |
$413,000 and above |
$491.60 |
Get started with Medicare
Getting Medicare is a major milestone. Here’s where you can get the information you need, no matter where you are in your Medicare journey. Before you choose a path below, check out these 5 important facts:
Your Medicare coverage choices
Note |
New to Medicare? Get the basics. |
When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get your Medicare coverage—Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Some people need to get additional coverage, like Medicare drug coverage or Medicare Supplement Insurance (Medigap).
Use this information to help you compare your coverage options and decide what coverage is right for you.
Original Medicare
Note |
If you don't get Medicare drug coverage or Medigap when you're first eligible, you may have to pay more to get this coverage later. This could mean you’ll have a lifetime premium penalty for your Medicare drug coverage. |
Learn more about how Original Medicare works.
Medicare Advantage (also known as Part C)
Learn more about how Medicare Advantage Plans work.
Call Reynold Jones Insurance Group at 817-545-3900 Ext. 102 for Individual Consultation
Explore All of this and More at www.Medicare.gov