If you’ve been covered by employer-sponsored health insurance most of your life, you probably never had a reason to distinguish between the different parts of your coverage.
When you qualify for Medicare, you’re first enrolled in Medicare part A and Part B. Their enrollment and eligibility are generally the same but have differences in costs and coverage.
Medicare Part A covers hospital expenses, skilled nursing facilities, hospice, and home health care services, while Medicare Part B covers outpatient medical care such as doctor visits, x-rays, bloodwork, and routine preventative care.
The two parts together form Original Medicare.
Let’s discuss more about them in brief.
What is Medicare Part A?
Sometimes referred to as “hospital insurance”, Part A covers hospital stays and inpatient treatment. For treatment to be covered by Medicare Part A, it must be deemed medically necessary. This means a doctor has agreed that the treatment is required to prevent or treat a condition or illness.
You typically pay a deductible and coinsurance and/or copayments. As for premium, if you have worked for at least 10 years i.e. 40 quarters while paying taxes, then you don’t pay a premium for Part A. If you have worked for less than 30 quarters, you generally pay $458 per month in 2020.
What is Medicare Part B?
Medicare Part B is known as “medical insurance” because it covers doctor visits and medical care outside the hospital. Like with Medicare Part A, treatment must be determined as medically necessary or preventative to be covered by Medicare Part B. While Medicare Part A is required for some people on disability or those receiving other forms of government aid, Medicare Part B is not mandatory for these people.
Under Part B, in most cases you will pay 20% of the Medicare-approved amount for each item or service and a deductible may also apply. The premium for Part B may be higher if your income is above a certain amount.
Can you get both Part A and Part B coverage at the same time?
It’s possible to get Part A and Part B coverage at the same time when you’re an inpatient in a hospital. For instance, while Part A generally covers medically necessary surgery and certain hospital costs, Medicare Part B may cover doctor visits while you’re an inpatient.
Are There Alternatives to Medicare Parts A and B?
Yes. If you are still working, you could stay on your employer’s insurance plan. However, be aware that you may pay a penalty if you later enroll in Medicare outside of your enrollment period.
If you want Medicare benefits but need more flexibility than Parts A and B, you could opt for Medicare Part C, also known as Medicare Advantage.