Are you looking for Medicare options in Madison, Mississippi? Look no further! Our licensed agents at Bobby Brock Insurance are experts in everything Medicare and can help you navigate all the Medicare options you have in Mississippi.
We can help you understand all the working parts of Medicare and which options are best for you. Let’s go through the basics now!
The Parts of Medicare
First, you need to learn the lingo. Let’s discuss each component of Medicare and which parts of Medicare are offered in Madison, MS.
Part A: Coverage and Cost
Part A is hospital insurance. This is the part of Medicare that will help pay for the room and board charges you’ll receive during an inpatient hospital stay. It will also cover the room and board expenses during a stay at a skilled nursing facility.
Part A will not cover 100% of your room and board expenses. You’ll be responsible for your deductible as well as the coinsurance costs. The deductible in 2022 is $1556. The Part A deductible must be met for each benefit period. A benefit period begins on the first day of your hospital stay and ends after you have remained out of the hospital for 60 consecutive days. If you are admitted as an inpatient later in the year, you’ll need to pay that deductible all over again.
Once the Part A deductible has been met, the coinsurance amounts are based on the length of your stay. You will have no coinsurance costs for the first 60 days. Starting on day 61, you’ll be responsible for $389 each day, up to day 90. After that, your Part A benefits are exhausted, and you’ll be responsible for the entire cost. However, you are given 60 lifetime days to use and can use those if you have not depleted them. During your 60 lifetime day period, your coinsurance cost is $778 each day.
It’s obvious that coinsurance expenses for Part A can add up quickly, especially if you have a long stay or must meet your deductible multiple times in one year. On the bright side, you’ll likely be receiving Part A coverage premium-free.
If you or your spouse paid Medicare taxes for ten years, you would not pay anything for Part A coverage. If you haven’t, your premium will be either $274 or $499, depending on how many quarters you paid Medicare taxes.
Part B: Coverage and Cost
Part B is outpatient insurance. It will pay for roughly 80% of outpatient expenses like doctor’s visits, surgeries, diagnostic lab tests and images, durable medical equipment, and preventive services. You will need to meet the annual deductible of $233 before your Part B coverage begins.
Part B does have a monthly premium. In 2022, the standard monthly premium is set at $170.10. Individuals with high incomes may pay an adjusted amount called the Income-Related Monthly Adjustment Amount or IRMAA. To determine if you will be charged an IRMAA, the Social Security Administration looks at your Modified Adjusted Gross Income from two years prior. If you made over a certain amount, you’d pay more for Part B. There are different levels of IRMAA. The most any Medicare beneficiary will pay for Part B is $578.30.
Part C: Coverage and Cost
Part C of Medicare is also called Medicare Advantage. Medicare Advantage is an all-in-one alternative to Orignal Medicare. If you are enrolled in Original Medicare, your benefits come from the federal government. If you are enrolled in Medicare Advantage, your benefits will come directly from the insurance company you purchased the plan through.
Part C plans have the same coverage as Parts A and B but often come with additional benefits. Many plans include prescription drug coverage and may also offer benefits for transportation, gym memberships, dental, vision, and hearing services, and more.
There is no one set premium or deductible for Part C since the plans will vary. Not all plans are available everywhere, and all insurance companies who offer them have formulated their own unique plans.
Most Part C plans have low premiums, some even as low as $0. However, that doesn’t mean the plan is free! You’ll still have copays and coinsurance costs, and you are still responsible for paying your Part B premium.
Part D: Coverage and Cost
Part D of Medicare is prescription drug coverage. These can be purchased as a stand-alone plan or may come as part of your Medicare Advantage plan. Either way, the plans work the same way.
Every Part D plan has a drug formulary. The formulary is the list of prescription drugs covered by the plan and is categorized by tiers. Common medications fall into lower tiers, and specialized medications are placed in higher tiers. As you probably guessed, medications in higher tiers are more expensive.
Your premium will be based on the plan you choose. Individuals who take several medications or who are on specialized prescriptions will need a more robust plan, resulting in higher premiums. Most Part D plans employ the standard deductible of $480.
That wraps up the parts of Medicare. There is one more Medicare product that you need to know about – Medicare supplements.
Medicare Supplements: Coverage and Cost
Medicare supplements, or Medigap plans, are an alternative to Medicare Advantage. (You’ll want to enroll in one or the other.) A Medigap plan helps pay for the costs that remain after Original Medicare has paid its share.
Medigap plans work quite differently than Medicare Advantage plans. They are typically more expensive but have fewer copays and coinsurance costs. In fact, enrolling in one of the more popular plans can leave you with nearly no out-of-pocket expenses for healthcare. However, Medigap plans do not offer any additional benefits outside of the services covered by Original Medicare.
There are ten Medigap plans available, and your premium will largely depend on which of the ten you choose. None of the plans have a deductible.
Madison, Mississippi Medicare Advisors
There is so much to understand about Medicare, no one can be expected to learn it all. Fortunately, that’s why most beneficiaries choose to work with a Medicare advisor. Our independent Medicare advisors in Madison, MS, can educate you on the options you have and help you pick plans that would provide you with the most beneficial coverage. Our services are provided at no additional cost to you. Give us a call today and find out how we can help you on your Medicare journey.