E.F. Heagen & Associates

(949) 487-6711

Insurance Read Time: 3 min

Breaking Down the Parts of Medicare

Generally, the different parts of Medicare help cover specific services. Most beneficiaries choose to receive their Parts A and B benefits through Original Medicare, the traditional fee-for-service program offered directly through the federal government. It is sometimes called Traditional Medicare or Fee-for-Service (FFS) Medicare. Under Original Medicare, the government pays directly for the health care services you receive. You can see any doctor and hospital that takes Medicare (and most do) anywhere in the country.

In Original Medicare:

  • You go directly to the doctor or hospital when you need care. You do not need to get prior permission/authorization from Medicare or your primary care doctor.
  • You are responsible for a monthly premium for Part B. Some also pay a premium for Part A.
  • You typically pay a coinsurance for each service you receive.
  • There are limits on the amounts that doctors and hospitals can charge for your care.
  • If you want prescription drug coverage with Original Medicare, in most cases you will need to actively choose and join a stand-alone Medicare private drug plan (PDP).

Note: There are a number of government programs that may help reduce your health care and prescription drug costs if you meet the eligibility requirements.

Unless you choose otherwise, you will have Original Medicare. Instead of Original Medicare, you can decide to get your Medicare benefits from a Medicare Advantage Plan, also called Part C or Medicare private health plan. Remember, you still have Medicare if you enroll in a Medicare Advantage Plan. This means that you must still pay your monthly Part B premium (and your Part A premium, if you have one). Each Medicare Advantage Plan must provide all Part A and Part B services covered by Original Medicare, but they can do so with different rules, costs, and restrictions that can affect how and when you receive care.

It is important to understand your Medicare coverage choices and to pick your coverage carefully. How you choose to get your benefits and who you get them from can affect your out-of-pocket costs and where you can get your care. For instance, in Original Medicare, you are covered to go to nearly all doctors and hospitals in the country. On the other hand, Medicare Advantage Plans typically have network restrictions, meaning that you will likely be more limited in your choice of doctors and hospitals. However, Medicare Advantage Plans can also provide additional benefits that Original Medicare does not cover, such as routine vision or dental care.

© Medicare Rights Center. Used with permission.

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright FMG Suite.

Share |
 

Related Content

Financial Hacks for Millennials: Don’t Get Burnt With FIRE

Financial Hacks for Millennials: Don’t Get Burnt With FIRE

Financial Independence, Retire Early (FIRE), also known as radical savings, encourages aggressive saving to retire by age 40.

7 Easy Ways to Improve Your Finances This Week

7 Easy Ways to Improve Your Finances This Week

Improving your financial life doesn’t have to be tedious and time-consuming. These easy actions can lead to improvements in a

Are You and Your Partner Trapped by the Money Taboo?

Are You and Your Partner Trapped by the Money Taboo?

Were you raised with the money taboo? Many people are taught from a young age not to speak openly and honestly about money, even with their loved ones. This might not seem like a big deal, but the money taboo has real consequences.

 

Have A Question About This Topic?







Thank you! Oops!

Gap Insurance for Leased Cars

If you’re thinking of leasing a new car, then you shouldn’t forget about gap insurance.

Pickleball in Retirement

Learn about the latest sport to sweep the nation with this informative article.

Term vs. Permanent Life Insurance

When considering life insurance, it's important to understand your options.

View all articles

Home Mortgage Deduction

Use this calculator to assess the potential benefits of a home mortgage deduction.

Federal Income Tax

Use this calculator to estimate your income tax liability along with average and marginal tax rates.

Taxable vs. Tax-Deferred Savings

Use this calculator to compare the future value of investments with different tax consequences.

View all calculators

5 Smart Investing Strategies

There are some smart strategies that may help you pursue your investment objectives

Your Cash Flow Statement

A presentation about managing money: using it, saving it, and even getting credit.

Managing Your Lifestyle

Using smart management to get more of what you want and free up assets to invest.

View all presentations

What You Need to Know About Social Security

Every so often, you’ll hear about Social Security benefits running out. But is there truth to the fears, or is it all hype?

The Independence of Financial and Emotional Well-Being

Greater financial and emotional confidence brings greater independence. Isn’t that what it’s all about?

The Cost of Procrastination

Procrastination can be costly. When you get a late start, it may be difficult to make up for lost time.

View all videos