Medicare in 2020
Everyone has heard of Medicare and over the years, here at Total Benefit Solutions have posted numerous articles explaining how Medicare works. We even wrote out a post about the history of Medicare a little over a year ago (That post can be found here ). However, nothing in the Insurance World stays still and every so often we like to revisit this sector of the Insurance Market and explain how Medicare works with some updates. This way, whether you’re new to Medicare, or you’ve been on it for a while, you are up-to-date on how your Insurance Plan works!
Original Medicare (Part A and Part B)
With Medicare Part A, you typically do not pay a premium for the coverage. However, if you have not been disabled for 24months or you or your spouse have not worked more than 30 Medicare-taxed quarters, you may have to pay a premium for Part A. In 2020, the Part A Premium is between $240-$437 per month. Part A also has a deductible. In 2019, it was $1,364 but in 2020, it may increase to $1,420.
So what does Part A Cover?
Medicare Part B handles all your “outpatient” services, but not many. For Medicare Part B, your premium is deducted from your benefit check if you receive Social Security, Railroad Retirement Board, or the Office of Personnel Management. If you do not get these benefit payments, you will get a bill. In most cases, you will need to sign up for Part B. To find out if you need to and how, please click here. In 2019, the Part B Premium for most people will be $144.30 (as of now, this is projected and not officially released, but in 2019 it was $135.50); However, some will not. Click here for more information on how much you should expect to pay.
So what does Part B Cover?
Part B has a deductible. The deductible for Part B for 2019 was $185, but is projected to be raised to $197. After that, Part B covers:
- Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
- Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best. You pay nothing for most preventive services if you get the services from a health care provider who accepts Medicare.
- Part B Also covers things like: Clinical research, Ambulance services, Durable medical equipment (DME), Mental health (Inpatient, Outpatient, Partial hospitalization), Getting a second opinion before surgery, Limited outpatient prescription drugs
To find out if any service is covered under Medicare Part A or Part B, Click Here for a quick search tool.
Once you have the two components of Original Medicare, you get a choice. Under Original Medicare, between the deductibles, the limited benefits, and the high co-insurance, it isn’t really a “great” plan. It doesn’t even include most Rx! So what do you do? You either go after a Medicare Supplement or a Medicare Part C (Advantage) Plan.
Because we are talking about the ABCD’s of Medicare, I’ll skip Supplements, but there is a whole article here on them. Total Benefits offers Supplement and Advantage Plans, so when you call us we can discuss both options for you!