Medicare Basics Part 2: Medicare B & C
Horizons in Hemophilia, November 2011
By Robert Gillespie, LMSW, Social Worker
Medicare Parts A and B are the best known areas of Medicare. As discussed in the previous article, Medicare Part A is automatically awarded when a person becomes eligible for Medicare. A little known fact is that Medicare Part B is an optional aspect of the program and usually the recipients must pay monthly deductibles to keep Medicare Part B. A basic definition of Medicare Part B is medical insurance to pay for medically necessary services and supplies provided by Medicare. In short, Medicare Part B covers outpatient care, doctor's services, physical or occupational therapists, additional home health care as well as certain labs, some preventive shots, and some chiropractor services.
Medicare Part B covers many services, tests, preventive treatments, etc. that are common among health care patients, but are not covered in the Medicare Part A plan. Although many services and products are covered, the recipient is responsible for a portion of the cost, also known as a monthly premium, which is usually 20%. Some individuals qualify for assistance paying the 20% deductible.
Medicare Part C, also known as the Medicare Advantage Plan, operates in much the same way as a traditional HMO or PPO. If chosen by the recipient, Medicare Parts A, B, and often D (prescription drug coverage) are combined into one benefit. Many private health insurance companies such as United Healthcare and Aetna are certified by Medicare to provide bundled benefits to recipients. As with many HMOs and PPOs, recipients must use in-network providers.
In the next installment of this series, the newest aspect of Medicare, Part D, will be discussed.
A reminder: Medicare open enrollment began October 17 and runs until December 7, 2011. Please contact your HoG Social Worker if you have questions about Medicare Open Enrollment.