This is a document in process as I attempt to figure this stuff out.
The Alphabet Soup
Part A covers hospitalization and costs you nothing. I think the reason is that, as expensive as hospital care is, it only takes a few trips when you are past your "Best By" age to remove from Social Security and Medicare.
If you paid Medicare taxes (and how, if you were employed, would you not?) it's free:
[M]ost people get premium-free Part A. You can get premium-free Part A at 65 if:Part B covers non-hospital medical costs.
If you're under 65, you can get premium-free Part A if:
You pay $166 per year for your Part B deductible. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment.The cost is $121.80 per month deducted from your Social Security or Social Security Disability check. Preventative care such as annual physicals are not subject to deductible so free.
Part C are Medicare advantage plans in which the governments hands over your Part B premiums to a private insurer along with money from you. Still trying to figure out why you would sign up for this. More below as I figure it out.
Part D is a prescription drug coverage program is a private sector insurance program which you pick. Some Medicare Advantage programs (Part C) include Part D. This is so confusing to me that I suspect many people make less than optimal choices. There is a monthly premium (which varies enormously, from $18.40 to $162.10 here in Idaho), an annual deductible varying from $0 to $360 with exemptions for Tier 1 and Tier 2 drugs (not yet sure what those are) and every plan has its own "formulary" which is a list of covered drugs showing what you will pay for them. Something I do not understand yet is "Gap Coverage" (also known as "the donut hole" but it appears to be some limit on your annual coverage. This explains it. Once you exceed the maximum amount, you pay the full prescription costs until you reach the catastrophic coverage level (total drug costs: $6154, at which point you pay 5% of drug costs. This gap is supposed to phase out in 2020.
It appears that a very large percentage of Part D beneficiaries reach the coverage gap. I would guess these are people with serious health problems (the kind you and I will never have).
So what does Part C (Medicare Advantage) cover that Part B doesn't? It would appear costs that exceed the Medicare-approved amount. But how do I find that schedule to see if Part C makes sense? I can't find it. The amount of advertising I see for these plans makes me wonder if they are sensible. How many of you have experienced costs that were above the Medicare-approved amount? I understand many providers simply eat the difference, which might explain the reluctance of many doctors to take Medicare.
A friend used to sell Medicare Advantage plans and referred me to Services for People on Medicare
(Senior Health Insurance Benefits Advisors Program - SHIBA), an Idaho state program that apprently drives insuers crazy for giving unbiased information. I'll call them Monday.