Medicare Insurance Guide
Many health insurance plans only offered coverage to young individuals. This means that individuals aged 65+ years were left out of the plan. To fill this gap, Medicare was introduced in 1965 by former president Lyndon Johnson to take care of the health matters of individuals aged above 65 years. This insurance covers their regular treatment, hospital bills, and purchase of prescription drugs for aged persons.
Medicare operates similarly to the standard health plans but its monthly premiums are quite affordable. This article reveals all the details you should keep in mind about Medicare Insurance.
What’s The Difference Between Medicare And Medicaid?
To start with, both Medicare and Medicaid are federal health insurance services meant to offer cheap coverage to various sets of individuals. Medicare provides coverage to those over 65 years while Medicaid offers free insurance to people with low incomes.
Medicare Eligibility
As stated earlier, Medicare caters to seniors. However, some exceptions may see younger people join it. Here are the exemptions:
- Patients who require a kidney transplant or just dialysis.
- Young people who have serious health complications or have disabilities.
- People who have been awarded their social security benefits.
- People who are beneficiaries of the Railroad Retirement Board’s disability service.
- Patients who are on kidney dialysis or who need a kidney transplant.
NB: It is worth noting that the government deducts taxes from each individual’s paycheck to fund Medicare. That is why it is free for people above 65 years.
What Does Medicare Cover?
Medicare offers these plans:
- Medicare Part A takes care of basic hospitalization.
- Medicare Part B provides you with coverage for diagnostic tests, visits to the doctor, etc.
- Medicare Part C (also called Medicare Advantage) caters to everything included in Part A and B.
- Medicare Part D is meant for people taking prescription drugs.
- Medicare supplement coverage takes care of out-of-pocket costs like co-insurance.
What Is Medicare Advantage?
Introduced in 1997, Medicare Advantage (Medicare Part C) offered the same coverage as Part B and A. However, this coverage allowed you to enroll via a private insurance plan especially if they wanted to get better insurance coverage.
Can I Drop or Change My Medicare Advantage Plan?
Yes, you can drop your Medicare Advantage plan or even enroll in another plan. To do so, you will need to apply for the new plan during their enrollment period which lasts from 1st January to 31st March.
To change from Medicare Advantage to Original Medicare, you should call the Social Security officials or apply through their website.
What’s The Difference Between Medicare Part A, B, C and D?
Check out these key distinctions of the four parts of Medicare:
Medicare Part A: Hospital Insurance
Medicare Part A is the basic coverage that provides coverage for emergency costs like:
- Hospital bills
- Ambulance rides
- Emergency room treatment
- Short-term stays in nursing centers
Medicare Part B: Medical Insurance
Medicare Part B will take care of what Part A lacks such as outpatient care, especially after surgery.
Also, this coverage provides funds for specialist doctors like gynecologists. Through this plan, you can also get medical equipment such as wheelchairs and walkers.
Medicare Part C: Medicare Advantage Plans
All the benefits of both Part A and B are included in Medicare Part C. However, Part C is a big deal since it allows you to get Medicare coverage through enrolling in a private health insurance plan.
Notably, this type of insurance is only given to people who have been working with a long-standing firm that takes care of their insurance premiums.
Medicare Part D: Prescription Drug Coverage
To start with, Part D also offers all the benefits you would enjoy in Parts A and B. However, it is purposely meant for prescription drugs. Notably, Part D only covers either 20% or 30% of the total cost of the prescription drugs.
How Much Does Medicare Cost Per Month/Year?
The Medicare costs are similar in all states.
How Much Does Medicare Part A Cost?
Medicare Part A, which covers hospital care, is free and accessible in 99% of the cases.
How Much Does Medicare Part B Cost?
You may expect to pay a deductible of about $203.
How Much Does Medicare Part C Cost Per Month/Year?
Here is a table showing the cost of Medicare Part C per month and year across all the states in the U.S:
State | Average Medicare Part C Cost Per Month | Average Medicare Part C Cost Per Year | Average Drug Deductible |
Alabama | $25 | $300 | $140 |
Arizona | $12 | $144 | $138 |
Arkansas | $22 | $260 | $210 |
California | $21 | $252 | $140 |
Colorado | $22 | $260 | $100 |
Connecticut | $39 | $348 | $177 |
Delaware | $23 | $276 | $66 |
Florida | $8 | $96 | $99 |
Georgia | $19 | $228 | $178 |
Hawaii | $36 | $432 | $202 |
Idaho | $32 | $384 | $134 |
Illinois | $26 | $312 | $108 |
Indiana | $18 | $216 | $102 |
Iowa | $28 | $336 | $68 |
Kansas | $17 | $204 | $92 |
Kentucky | $18 | $216 | $95 |
Louisiana | $26 | $312 | $162 |
Maine | $23 | $276 | $173 |
Maryland | $55 | $660 | $89 |
Massachusetts | $61 | $732 | $221 |
Michigan | $51 | $612 | $62 |
Minnesota | $62 | $744 | $288 |
Mississippi | $17 | $204 | $286 |
Missouri | $10 | $120 | $98 |
Montana | $42 | $504 | $350 |
Nebraska | $13 | $156 | $116 |
Nevada | $12 | $144 | $129 |
New Hampshire | $31 | $372 | $232 |
New Jersey | $25 | $300 | $199 |
New Mexico | $28 | $336 | $233 |
New York | $33 | $396 | $234 |
North Carolina | $18 | $216 | $142 |
North Dakota | $64 | $768 | $336 |
Ohio | $21 | $252 | $98 |
Oklahoma | $15 | $180 | $108 |
Oregon | $44 | $528 | $148 |
Pennsylvania | $44 | $528 | $34 |
Rhode Island | $25 | $300 | $58 |
South Carolina | $13 | $156 | $147 |
South Dakota | $42 | $504 | $296 |
Tennessee | $21 | $252 | $118 |
Texas | $11 | $132 | $164 |
Utah | $19 | $228 | $157 |
Vermont | $26 | $312 | $142 |
Virginia | $20 | $140 | $164 |
Washington | $39 | $468 | $138 |
West Virginia | $32 | $384 | $110 |
Wisconsin | $34 | $408 | $218 |
Wyoming | $57 | $684 | $277 |
NB: Medicare Advantage plans are not available in Alaska
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How Much Does Medicare Part D Cost?
Please find the Medicare Part D cost comparison in 2023 below.
State | Medicare Part D Cost Per Month | Medicare Part D Cost Per Year | Average Deductible |
Alabama | $39 | $468 | $332 |
Alaska | $33 | $396 | $362 |
Arizona | $37 | $444 | $322 |
Arkansas | $36 | $432 | $322 |
California | $41 | $492 | $328 |
Colorado | $39 | $468 | $331 |
Connecticut | $38 | $456 | $326 |
Delaware | $32 | $384 | $349 |
Florida | $42 | $504 | $339 |
Georgia | $34 | $408 | $334 |
Hawaii | $34 | $408 | $356 |
Idaho | $40 | $480 | $333 |
Illinois | $37 | $444 | $334 |
Indiana | $31 | $372 | $335 |
Iowa | $38 | $456 | $337 |
Kansas | $33 | $396 | $332 |
Kentucky | $31 | $372 | $339 |
Louisiana | $35 | $420 | $340 |
Maine | $34 | $408 | $338 |
Maryland | $32 | $384 | $358 |
Massachusetts | $38 | $456 | $332 |
Michigan | $34 | $408 | $338 |
Minnesota | $38 | $456 | $337 |
Mississippi | $31 | $372 | $349 |
Missouri | $35 | $420 | $324 |
Montana | $38 | $456 | $338 |
Nebraska | $38 | $456 | $338 |
Nevada | $33 | $396 | $343 |
New Hampshire | $34 | $408 | $338 |
New Jersey | $40 | $480 | $335 |
New Mexico | $39 | $468 | $339 |
New York | $40 | $480 | $325 |
North Carolina | $36 | $432 | $338 |
North Dakota | $38 | $456 | $339 |
Ohio | $33 | $396 | $348 |
Oklahoma | $35 | $420 | $360 |
Oregon | $38 | $456 | $340 |
Pennsylvania | $42 | $504 | $324 |
Rhode Island | $38 | $456 | $336 |
South Carolina | $42 | $504 | $338 |
South Dakota | $38 | $456 | $342 |
Tennessee | $39 | $468 | $342 |
Texas | $38 | $456 | $341 |
Utah | $40 | $480 | $333 |
Vermont | $38 | $456 | $334 |
Virginia | $32 | $384 | $346 |
Washington | $38 | $456 | $343 |
West Virginia | $42 | $504 | $325 |
Wisconsin | $39 | $468 | $320 |
Wyoming | $38 | $456 | $344 |
Do I Need Private Health Insurance if I have Medicare?
If you are above 65 years, you will not require any other insurance plan because you are already well-covered. So, you do not have to keep the insurance plan you have been relying on when you did not qualify for Medicare.
What Is The Best Medicare Coverage Plan?
Medicare offers Parts A, B, C, and D. Parts A and B are free to individuals aged at least 65 years or those with a serious disability. However, if you intend to enjoy more benefits regarding treatment, you can pay a higher premium for part C plans.
Does Medicare Part B Include Dental Insurance?
No, part B does not offer any form of dental coverage. This means you will have to get a third-party insurer or pay out of pocket to have your teeth fixed.
Alternatively, you can get a Medicare Advantage care plan through your preferred private insurance company. As stated earlier, this plan allows you to enjoy additional coverage through bundled dental insurance.
How Do I Sign Up For Medicare Plans?
To enroll in Medicare, visit the nearby Social Security Administration office to check the plans, get guidance, and make your application. You can also apply online if you can’t visit their offices.