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Medicare CostsMedicare CoveragePart APart B

What are the differences between Medicare Part A and B?

When joining Medicare, it’s essential to understand the differences between the two main parts of Medicare.

The two main parts of Medicare are Part A and Medicare Part B.

Medicare Part A primarily covers your hospital visits. It also includes coverage for services like skilled nursing, mental health, and hospice.

If you or your spouse have worked for 40 quarters (which is ten years), and you’ve paid your FICA taxes, you do not pay anything for Part A premiums. You’ve pre-paid into Part A premiums through your FICA payroll taxes.

With that said, if you have not worked 40 quarters, then Part A premiums can cost you up to $437 each month.

Medicare Part B covers most of what you will need when it comes to health care. It includes your doctor’s visits, your lab tests, your therapy, and your durable equipment.

Please be aware that Medicare won’t pay for prescriptions unless it must be administered by a medical professional. Most of the time, you will be using Medicare Part B.

The price for Part B ranges depending on your situation, but most people will pay $135.50 each month for Part B (in 2019).

It’s also important to note that the monthly premiums can be lower if you qualify for financial help, but it can also be higher if you have a higher income.

For example, if your Modified Adjusted Gross Income (it’s based on your taxes) is $85,000 or more as an individual or $170,000 as a couple, you will pay more for Part B. The government looks at your income for up to two years back to determine what you pay for Medicare.

With that said, we help our clients know when and how to appeal these additional fees or how to manage potentially large employer payouts to avoid paying more for Medicare.

One key thing to understand is that Medicare doesn’t cover 100 percent of most of your health care expenses. Medicare pays for 80 percent of the cost of medically necessary services, and you, or other types of Medicare add-ons, cover some to all of the remaining 20 percent.

That means, if you only sign up for Medicare Part A and B, you should expect to have sizable additional health care expenses if you see the doctor or run into health issues.

Medicare is complicated, but it doesn’t have to be. To easily make the right Medicare decision you can CLICK HERE to sign up for our Medicare Enrollment Concierge.