The Abc's (and D's) Of Medicare

By Diane Schlindwein

December 27, 2016 4 min read

Seniors may have been reciting the alphabet for over 60 years, but when it comes to the four parts of Medicare -- Part A, Part B, Part C and Part D -- many people are far less well-versed. In fact, anyone who thinks that signing up for the medical plan for seniors is simple could be in for a rude and costly awakening.

"People need to realize that enrolling in Medicare can be complicated," says Chris Orestis, a senior-care advocate and author of the books "A Survival Guide to Aging" and "Help on the Way." "If you don't pay attention, you can end up missing needed coverage or paying more out-of-pocket expenses in premiums, co-pays and deductibles than you realize -- or can afford."

For starters, it's important to understand that Medicare is a federal health insurance program that covers most people 65 or older and some people who are younger who have disabilities. It also covers some people with end-stage renal disease.

Medicare coverage comes in two primary forms from which participants can choose. The original Medicare is the above-mentioned traditional federal-government-administrated program, which most seniors 65 or older qualify for automatically. The other form of coverage is through Medicare Advantage plans, which are sold by private insurance companies. The Advantage plans sometimes offer additional services, such as routine vision, hearing and dental care.

Orestis says that most people have probably heard of Medicare Parts A and D but don't fully understand all aspects of Medicare.

Here's how the "alphabet" breaks down:

Medicare Part A pays for hospital and skilled-nursing-facility care, but not doctors' fees. It also pays for some home health care and hospice care. You are automatically enrolled in Part A when you enroll in Medicare through your own or your spouse's Social Security records. You likely won't have to pay a monthly premium for Part A.

Medicare Part B is voluntary and pays 80 percent of costs for doctors, outpatient services, lab tests, X-rays, ambulance rides and medical equipment. It has a monthly premium.

Medicare Part C is a private Advantage plan. You must be enrolled in both Part A and Part B to enroll in Part C.

Medicare Part D pays for prescriptions. It is optional and offers some help with the outpatient prescription drugs that seniors often require. The coverage is voluntary and the monthly premium varies depending on how much coverage you have.

Anyone who regularly visits doctors or has been hospitalized knows that deductibles and co-pays can add up quickly -- and even with some explanation, many people are concerned or puzzled by how Medicare works.

Orestis says a good place to learn more is the Center for Medicare and Medicaid Services website, which provides a plethora of information and resources to review and assist enrollment.

However, you need to make a decision and do it in a timely manner, Orestis says. "When it comes (time) for Medicare enrollment, not being informed and missing deadlines can cause delays and penalties that can have a negative impact on your coverage and your wallet."

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