Medicare A, B, C and D

Randal C. Hill

50plus Magazine

WHEN WE START SCHOOL AS KIDS, WE LEARN OUR ABCS. Later, when we approach retirement, we are called upon to relearn those letters (plus a “bonus” D), this time to understand the parts of Medicare. While this time ‘round may feel more overwhelming than when we were kids, here’s help. Below, the four parts of Medicare are broken down into their simplest form. Understanding the parts will go a long way in making enrollment and coverage review faster, easier and hopefully, stress free.

Part A

Insurance that covers hospital stays, skilled nursing care and home, health and hospice care.

Most people don’t have to pay a premium for Part A. This because they met that obligation through Medicare tax deductions on their paycheck during their working years. Part A isn’t totally free, though, as you pay a deductible each time you begin a hospital stay; the 2023 deductible is $1,600. Because of this, you may want to purchase a supplemental policy to cover such a cost, as well as miscellaneous services that may incur out-of-pocket expenses when covered only by Part A.

Part B

Medical insurance involving care from doctors and other healthcare providers, as well as lab tests, diagnostic screenings, shots and vaccines, ambulance transportation, durable medical equipment (DME) and yearly “wellness” visits.

You may want to defer signing up for Part B if you are still working and have insurance through your job or are covered under your spouse’s health plan.

Part B monthly premiums for 2023 are $164.90. (Or possibly higher if your annual income exceeds $97,000.) For 2023, the annual deductible is set at $226. You are responsible for 20% of charges for doctor visits and other outpatient services. For those collecting Social Security, Medicare Part B premiums will be deducted from your monthly benefit.

Part C

This is Medicare Advantage, a private company’s Medicare-approved plan that typically offers extra benefits and is often “bundled” with Parts A, B and possibly D.

With an Advantage plan, you will probably use doctors in the plan’s network. In recent years, such plans have covered extras like wheelchair ramps and shower grips for homes, meal delivery and transportation to and from doctors’ offices. Other potential extra benefits may include vision, dental and hearing services.

Part D

Prescription drug coverage. While Part D pays part of your prescription drug costs, be aware of the so-called “donut hole” here. Once your total drug costs reach $4,660 in 2023, you become responsible for 25% of the price of any remaining prescription drugs purchased during the year. If your drug costs continue to mount, you may be able to qualify for catastrophic coverage. For 2023, when you have paid $7,400 for medicines — just what you paid, not including what Part D paid — you will be responsible for 5% of the cost for each of your drugs.

Programs change annually, so it’s important to review your plan every year. Professional assistance is available in most communities, and typically free of charge.