Skip to main content

Overview of the Four Parts of Medicare


If you recently had a medical procedure or were hospitalized, you may be confused about a recent bill and are wondering what Medicare will cover, what your gap insurance will cover, and what you will be responsible for. It may help to have a better understanding of the four main parts of Medicare.

Part A helps pay for inpatient stays in hospitals and skilled nursing facilities, some home care and end-of-life hospice care that accept Medicare. Hospital services covered include a semi-private room and meals, general nursing, drugs and supplies, inpatient rehabilitation, and some blood transfusions. Skilled nursing services include care for things like recovering from hip replacement surgery or stroke. Part A charges a deductible for hospital stays (the fee for 2025 is $1,676) but your Medigap insurance may cover that expense. Hospital stays for up to 60 days and virtually most services are covered by Medicare; but the one exception is not in a private room.

Part B covers doctors and outpatient services, and together with part A make up what is considered “Original Medicare.” Part B pays for diagnostic screenings, lab tests, preventive services, some medical equipment and transportation. It covers doctor visits and other outpatient services. There is a monthly premium with Part B, and in 2025 it is $185. For those making over $106,000 annually it may be higher. Part B only pays a portion of covered expenses and Medigap insurance policies are designed to cover some or all the difference depending on the plan.

Part C is what Medicare Advantage comes under, and is privately held insurance rather than Medicare, which is run by the federal government. If you choose Medicare Advantage, you will still need to sign up for Medicare part A and B and usually pay the premium for part B. Medicare Advantage plans set their own deductibles and you typically need to stay in a Network and use your plan’s approved providers or pay higher out of pocket costs.

Part D is again from a private insurer and pays for some of your prescription drugs. Generally there is a co-pay for each prescription, and you may have a premium, and a yearly deductible. Check with Medicare regarding rules for higher yearly drug costs and your responsibility.

Remember Medicare offers an open enrollment period each year to allow recipients to make changes to their plan. The period starts on October 15 and ends December 7. Any changes you make during this time will go into effect the following year.

At MorningStar at River Oaks, our 55+ community offers luxury assisted living with a variety of floor plans, onsite amenities, wellness programs and activities. For seniors with Alzheimer’s and other dementia-related diseases, our distinct Reflections Neighborhood provides specialized care. Visit our website to see what sets our community apart from other senior living in Houston and why MorningStar is a great place to call home.

MorningStar has considered it a privilege and responsibility to “cast a new light” on senior living, inspired and empowered by our unique mission: to honor, to value, to invest. Our passionate commitment to serving seniors has proudly earned us a reputation for satisfaction that is second to none. Contact us to learn more about the finest senior living apartments Houston has to offer.
Labels:

Comments

Post a Comment

Popular posts from this blog

MorningStar’s Luxury Senior Living in Houston

As senior living communities provide a range of benefits such as socialization, healthcare, amenities, and convenient services, it is no surprise it has become a popular lifestyle for many older adults. If your family has already started the search for senior living in Houston , you know there are many options. This may have left you wondering how to narrow down your search to find the optimal community for yourself or a loved one? Experts say the first thing to do is to find a home that provides the proper level of care. If you are a senior who needs help with the ADLs (activities of daily living), assisted living offers you the opportunity to maintain your sense of independence and get on with living your life to the fullest. In addition to 24/7 care managers, access to licensed nurses, and medication management, many assisted living communities offer services including meals, onsite amenities, scheduled transportation, housekeeping and more. They also often provide opportunitie...
Post a Comment
Read more

Memory Care Communities Provide a Safe, Welcoming Home

If a loved one suffers from Alzheimer’s or another dementia-related disease, at some point, you may require professional help. The number one concern at a memory care community is to ensure the safety of the person as many of the disease’s symptoms place the person more at risk for accidents and other mishaps. Forgetfulness and confusion are some of the most recognizable signs of Alzheimer’s disease and can cause problems like forgetting to turn off a stove, getting lost in familiar areas or wandering. Other common issues in the early stages of the disease include vision/spatial issues and impaired reasoning and judgment, problem solving and difficulty in completing everyday tasks. Memory care communities are equipped to provide a safe, stable residential environment for seniors with memory impairment as well as provide meaningful activities to keep the person engaged. At most communities, the staff receives extensive training and information regarding the disease to better treat and ...
Post a Comment
Read more

Are You Ready for a Parent’s Unexpected Hospital Stay?

While many hospital stays are planned, older adults are more likely to require an unexpected trip to the hospital. When you have the luxury of time, it is easy to get prepared with the necessary information a parent needs when admitted to the hospital. It can be a different story if the trip is sudden. Medical experts say to ensure a loved one gets the proper care, it is important to see to it that the hospital has a complete medical history. Notes and documents can be completed and gathered now then updated as health changes occur. For starters, the hospital will want a “next of kin” contact for the patient so decide beforehand who that will be. Now go through the list of medications your parents take and make sure they are all together in one location. In the event of a medical emergency, you will be able to bring all their medications with you to ensure the hospital knows the most up-to-date medications and dosages. Another thing to gather information on regards your parents’ pre-...
Post a Comment
Read more