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What’s the Difference Between Medicare Part A and Part B?

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If you’ve been covered by employer-sponsored health insurance most of your life, you’re probably never had a reason to distinguish between the different parts of your coverage. Medicare, however, has separated hospital insurance (Part A) from medical insurance (Part B). Medicare Part A and B have differences in costs and coverage, but enrollment and eligibility are generally the same.

What is the difference in costs for Medicare Part A and Part B?

Medicare Part A and Part B have different premiums, deductibles, and coinsurance amounts.

Part A Part B
Premiums Most people get premium-free Part A. You generally qualify for premium-free Part A if you’re 65 and already get retirement benefits from Social Security or the Railroad Retirement Board. You can also get premium-free Part A if you’re under 65 and got Social Security or Railroad Retirement Board disability benefits for 24 months. Most people pay a premium for Medicare Part B. The standard Part B premium is $135.50 in 2019, or higher depending on your income.

 

Deductibles In 2019, the Medicare Part A deductible is $1,364 for each benefit period. The Medicare Part B deductible is $185 a year in 2019.
Coinsurance You pay a Part A coinsurance (a set dollar amount) for certain days in the hospital beyond day 60. This amount ranges from $341 to $682 per day in 2019. You pay 20% of the Medicare-approved amount for most doctor services under Medicare Part B. You generally won’t know the actual dollar amount until you receive a bill.

 

What is the difference of coverage for Medicare Part A and Part B?

Medicare Part A and Part B cover different things, and there is generally no overlap in coverage.

Part A coverage Part B coverage
·       Your hospital room and hospital meals

·       General nursing

·       Prescription drugs received in the hospital

·       Skilled nursing facility care

·       Hospice care

·       Home health care

 

 

·       Doctor visits both to primary care doctor and specialists

·       Some vaccines, including the flu shot

·       Mental health services

·       Annual physical exam

·       Durable medical equipment including wheelchairs and walkers

·       Emergency ambulance transportation

·       Physical, occupational, and speech therapy

·       Some preventive exams, tests, and screenings

 

What is the difference for eligibility for Medicare Part A and Part B?

People 65 and older and people with disabilities, End Stage Renal Disease, or Lou Gehrig’s disease are generally eligible for Medicare. You also must be a U.S. citizen or a permanent legal resident for at least five continuous years. You become eligible for Medicare Part A and Part B at the same time.

What is the difference for enrollment in Medicare Part A and Part B?

You may be enrolled in Medicare Part A and Part B automatically if:

  • You’ve been receiving Social Security or Railroad Retirement Board benefits for at least 4 months before you turn 65.
  • You’ve been receiving disability benefits for 24 months.

If you’re still working when you turn 65, you may not be automatically enrolled in Medicare Part A and Part B. You may choose to enroll in Medicare Part A if you can get it premium-free but delay Part B enrollment because you have to pay a premium for it.

Do have more questions about Medicare? Feel free to contact eHealth to speak with a licensed insurance agent. You can compare Medicare plans with the click of a button – just click Browse Plans on this page.

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