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If Medicare wasn’t confusing enough, there are both Medicare Parts A, B, C and D and Medicare Plans A, B, C and D. Let’s talk about the Parts of Medicare today and how the impact residents of Connecticut. Medicare Plans will be covered in the next post.

“Original Medicare” consists of Medicare Part A and Part B. The first enrollees in 1965 had these available. Both Medicare Parts A and B are still very much alive and cover medical expenses for millions of US citizens including many of us in Connecticut. Medicare Part C and D came along much later.

There are four parts to Medicare

  1. Medicare Part A (Primarily Hospital Coverage)
  2. Medicare Part B {Primarily Doctor Coverage)
  3. Medicare Part C (Covers Hospital, Doctors and usually Prescription Drugs)
  4. Medicare Part D (Covers Prescription Drugs Only)

There are 10 Medigap Plans. These plans supplement Original Medicare, by covering certain expenses that Original Medicare does not.

Medicare Part A Benefits and Costshares

Medicare Part A covers hospital expenses primarily. It will cover the bulk of the cost of a typical hospital stay. You will, however, be responsible for a deductible of $1,316 in 2017. A Medicare Supplement Plan can cover the deductible for you. Some of the plans available in Connecticut cover the deductible in full. Some cover a percentage of it. Other Connecticut Medicare plans do not cover it at all.

For longer hospital stays you may be responsible for more than the initial deductible. There are Medicare Supplement Plans that will, in most cases, cover these additional cost shares.

Medicare Part B Benefits and Costshares

Medicare Part B pays for expenses you incur in doctors offices and the offices of other providers such as physical therapists. You will have a much smaller deductible for doctor visits when compared to hospital stays.

The Medicare Part B deductible is $183 for 2017. You can only be asked to pay this once per calendar year. This probably means that you will pay for your first doctor visit of the year. After that Medicare Part B will cover 80% of the Medicare approved amount.

Your cost share may be more than 20%, however. Doctors are allowed to charge up to 15% over the approved amount.

Without additional coverage, you will be responsible for the $183 Part B (doctors) deductible plus 20% of the approved amount and up to 15% of excess charges. Some Medicare Supplement plans will cover some or all of these cost shares for you.

Medicare Part C Benefits and Costshares

Medicare Part C is one of the new kids on the block. It came on the scene after the “Medicare Prescription Drug Improvement and Modernization Act of 2003” was signed. Medicare Part C is also known as Medicare Advantage. There are about a half dozen carriers offering these plans in Connecticut.

Medicare Advantage plans are very popular. Although the coverage is not as comprehensive as the best Medigap Plans, the monthly premiums are much lower. Many people find this very attractive and are able to find plans that fit their budgets and medical needs.

Unlike Medicare Part A and Part B, Medicare Part C is provided by private insurers. I like to think that the “C” stands for comprehensive. Because these plans cover both hospital expenses and doctor visits. Most also cover prescription drugs.

Medicare Part C (Medicare Advantage Plans) act more like the plans you had or have that are not Medicare plans. Just like with other policies you might have had with an employer, you’ll present a card from your private insurer to your provider along with a copay for most services.

Medicare Part D

Medicare Part D is new also. It was breathed into life by the same law that create Medicare Part C. A Medicare Part D Plan is the same as a Prescription Drug Plan. You will typically pay a small copay four your medicines if you have one of these plans. You also get Medicare Part D from private insurers.

Some Options Are Incompatible

Prescriptions are covered by Medicare Part D. Costs for drugs are also covered by Medicare Part C (Medicare Advantage Plans) addition to other medical expenses. Because of this, In most cases, you cannot have both. There are exceptions, but in most cases enrolling in one will cause you to be automatically disenrolled from the other even if your Medicare Advantage Plan does not cover prescription drugs.

Typical Medicare Insurance Combinations

Most of my clients will chose one of these combination:

Coverage Combination 1

  • Medicare Part A (hospital)
  • Medicare Part B (doctors)
  • A Medicare Supplement (to pay some or all of what A & B do not cover)
  • Medicare Part D (prescription drug coverage)

Coverage Combination 2

  • Medicare Part C with built in prescription coverage

Both of these combinations provide comprehensive coverage for the typical medical expenses that most of us are concerned about. All options cover medical expenses incurred in hospitals, doctors offices and drug stores. Each has weaknesses and strengths. We’ll discuss the pros and cons in a future blog post.

I hope this makes the different Parts of Medicare less confusing. Call me or request personalized Connecticut Medicare recommendations from this site.

About Post Author

Alston J. Balkcom

“ Connecticut-licensed insurance agent since 1985.”

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If Medicare wasn’t confusing enough, there are both Medicare Parts A, B, C and D and Medicare Plans A, B, C and D. You will find links to Connecticut Medicare insurance information and prices.