Medicare Part A vs B: What You Need to Know

Did you know the average hospital stint can cost as much as $14,000 according to figures published by the CDC?

That makes healthcare a priority for aging Americans, who are bound to start experiencing increased medical issues. Fortunately, all US citizens over the age of 65 have access to affordable health insurance via the Federal Medicare program.

If you’re approaching retirement age, you’ll enjoy automatic enrollment in Medicare, so it’s important to figure out how it all works before then.

Medicare Part A vs B form part of the Original Medicare and are a staple of this healthcare program. Keep reading to uncover the mysteries of Medicare Part A vs. B.

What Is Medicare Part A?

Medicare Part A is a type of hospital insurance. It covers medically necessary hospital stays as prescribed by a doctor.

These in-hospital treatments may include preventive measures if a doctor deems them necessary. Part A also covers a few elements of home health care and nursing care in an approved facility.

This plan doesn’t cover the following:

• In-hospital doctor visits
• Private rooms
• Private-duty nursing care
• Items with a separate charge, like a TV or phone in the room
• Personal items, e.g. razors

Medicare Part A is compulsory for people receiving government aid or who are on disability.

What Is Medicare Part B?

Medicare Part B is a type of medical insurance. It covers medical care and doctor visits outside the hospital.

A doctor must prescribe all treatments valid under this healthcare plan, but it does include medically necessary preventive treatments and medication.

Unlike Part A, part B is not mandatory, but you might incur late penalties if you don’t sign up for it straight away. These are some of the most common things covered under Part B:

• Annual wellness exam
• Ambulance services
• Bone mass measurements
• Lab tests and blood work
• CPAP machines for sleep apnea
• Home health visits if medically necessary
• Specialist and doctor visits
• Preventive services, including flu vaccinations
• Tests and screenings for certain diseases
• Some diabetes supplies and equipment
• Medical equipment, like wheelchairs and walkers

Some services and treatments may attract a deductible or co-insurance payment, and you’ll need to qualify for some items and services.

Medicare Part B vs. A Costs

Medicare is free for all U.S. citizens and their spouses, provided they’re worked and paid taxes for at least ten years.

If you’ve only worked for between 30 and 39 quarters, you’ll pay a premium of $278 in 2023. The premium for those who’ve worked less than that is $506 for 2023.

The deductible for Medicare Part A is $1,600 and there are no co-payments for hospital stays under 60 days. For stays between 61 and 90 days, you pay $278, and you’ll pay $506 if you stay in the hospital longer than that.

You’ll pay $164.90 per month for Medicare Part B in 2023. This medical insurance only kicks in for expenses above $226 and includes a co-insurance payment of around 15% for most services.

Enrollment Periods for Medicare

In most cases, you’ll receive notification of your automatic Medicare Part A membership shortly before your 65th birthday.

If you’re not automatically enrolled, you must sign up during your Medicare Initial Enrollment Period. This period runs from three months before your 65th birthday, includes your birthday month, and ends three months after that.

It’s best to sign up for Part B at the same time.

In addition to Parts A and B, you can also sign up for Medicare Advantage plans, which offer a host of extra cover for those who need it. These plans fall under Part C of Medicare and include both parts of Original Medicare.

Additionally, you can opt for Gap Insurance to cover your co-payments and Part D drug coverage to pay for your prescription medications.

Medicare Part A vs B Exclusions

These parts of Medicare provide only the basics. So, you’ll need to consider alternatives if you need extra services that aren’t included.

For instance, according to this article, https://www.trustmedicare.com/does-medicare-cover-stair-lifts/, only Medicare Advantage plans cover extras like stair lifts.

Other common medical costs that fall outside the realm of these Medicare plans include:

• Acupuncture and other natural medicine
• Cosmetic surgery of any kind
• Dentures, veneers, and implants
• Dental care
• Optometry examinations
• Routine foot care
• Hearing-related items like hearing aids
• Long-term custodial care
• Prescription drugs

Unless you opt for a Medicare Advantage plan that covers any of the above, you’ll need to pay for these treatments yourself. You can also add a Part D prescription drug plan, but you must ensure it covers the drugs you need.

You’ll find a list of these medications on the ”formulary” for each plan. Each plan has a different list of inclusions and exclusions, so check before you sign up.

Medicare Advantage plans offer a lot of extras, but they have high monthly costs, so it’s important to consider these ongoing costs versus the cost of paying for necessary treatments and medication yourself.

You can switch to an Advantage plan if you need one later on, but you can only do so during the Annual Enrollment period, from October 15 through December 7. Remember, most Advantage plans will exclude pre-existing conditions.

Take Your Health Seriously

Taking time to understand the differences between Medicare Part A vs B as well as the other two kinds of Medicare plans can save you thousands of dollars in the future.

Knowing that you’ve taken care of your health needs will do much to ease your mind and ensure you enjoy your retirement to the fullest. So, it’s worth taking the time to investigate the best options for you.

Another way to stay safe and healthy is by taking good care of yourself every day. Browse our blog for more tips and information on how to eat and exercise for a healthier, happier life.