A CLOSER LOOK AT MEDICARE PARTS A & B

edicare Parts A & B (sometimes called "Original Medicare") is the federal government's standard health plan. It's similar to traditional employer-provided health insurance and provides two types of coverage.

• Part A helps with inpatient hospital costs.
• Part B helps with doctor's care and outpatient care.

If you choose Medicare Parts A & B, you can add a prescription drug plan (Part D) and Medicare Supplement Insurance to get benefits not provided by Parts A & B.

What's covered?

Part A helps cover:

• Hospital care
• Occasional inpatient care in skilled nursing facilities
• Hospice care and some home health care services, in some cases

Part B helps cover:

• Doctor visits
• Outpatient care, including preventive services such as cancer screenings, flu shots and annual physicals
• Some services not covered by Part A, such as physical or occupational therapy
• Medically required home health care services, in some cases

Are there limits to coverage?

Part A pays most of the costs of hospital stays lasting up to 60 days annually. Beyond that, you'll have to pay daily co-pays for each day you remain in the hospital. If you're hospitalized more than 90 days, you should expect to pay for the majority, if not all, of your care.

Part B doesn't usually limit the number of covered medical services you can receive, as long as your care is medically necessary to treat an illness or condition. However, some services, like preventive care and screenings, may have limits.

What doctors can I see?

Because coverage is available everywhere in the United States, you can go to any doctor or hospital in the country that accepts Medicare. No referrals are needed, even if you see a specialist. Care outside of the U.S. is not generally covered.

How much does it cost?

Part A

• Premium: For most people, the Part A monthly premium is free.
• Deductible: You must pay a deductible before Part A begins paying a share of your costs. If you have multiple hospital stays in one year, you may pay this deductible for each stay.
• Co-pays: You pay a daily co-pay after you've stayed a certain number of days in a facility, including hospital stays, skilled nursing care and some parts of hospice care.
• Coinsurance: You pay a small coinsurance payment if you use inpatient respite care for hospice patients. Respite care is short-term inpatient care that provides respite for the individual's family or other persons caring for the individual at home.

Part B

• Premium: You must pay a monthly premium for Part B. This monthly premium is usually deducted from your Social Security benefit.
• Deductible: You must pay a deductible before Part B begins paying a share of your costs.
• Co-pays: Outpatient hospital services have co-pays that range in price.
• Coinsurance: You currently pay 20% of the Medicare-approved amount for services after you meet the $135.00 deductible.

How do I enroll?

If you receive Social Security benefits when you become eligible for Medicare, you're automatically enrolled in Part A and Part B. However,if you don't want Part B coverage, you can opt out at your local Social Security office. If you don't receive Social Security benefits, but you're eligible for Medicare, you can enroll in Part A and Part B during your initial enrollment period at your local Social Security office. You can't be denied coverage because of your medical history or pre-existing conditions.

Tell Us Your Preferences

Share Your Preferences with AARP. Get the information you want. Take AARP's short preference survey to select which topics interest you. Click Here