Decoding Medicare Part A and B

Once you turn 65 you are eligible for Medicare health care insurance. Medicare is broken into 2 sections, Part A and Part B. These parts are broken down as follows:
Part A covers hospital benefits such as
  • Inpatient hospital stays
  • Inpatient skilled nursing facility care, except for long term care
  • Home health services for part time care
  • Hospice care
There are requirements that need to be met before Part A coverage begins. For a hospital stay your doctor and the hospital must agree that you need care. For skilled nursing facility your doctor certifies that you need care and you must spend the first 3 days in the hospital; this benefit will only last up to 100 days of care. For home health services doctor approved therapies and Hospice requires doctor certification that you have six months or less to live. There are no monthly premiums for this coverage, some people believe this is free but you did pay into FICA taxes your working life so essentially you already paid your premiums. There is an annual deductible of $1,184 and there are other deductibles based on the length of stay, ranging from $148 to $592 after you have exhausted either 60 days in the hospital or 20 days in a skilled nursing facility.
Part B covers other health expenses such as
  • Doctors' services
  • Outpatient Hospital Services
  • Medical Services & Supplies
  • Home Health Services
There is a long list of things that Part B does not cover and some of these are: dental care, vision care, cosmetic surgery, prescription medications, hearing aids, dentures, and long term care.
Part B operates differently than Part A, there is a monthly premium of $104.90 for most people. The premium could be higher if your annual income is greater than $85,000. This premium is automatically deducted from your monthly Social Security check. There is an annual deductible if $147. You are also responsible, if the services are covered by Medicare, coinsurance, charges above the Medicare approved amount, and all cost if the provider is not approved by Medicare. The coinsurance you are responsible for is 20% of all approved expenses after you meet your deductible of $147.
These charges are for 2013 and are reviewed annually by Social Security. The expenses are usually adjusted for inflation, which has been very low over the past few years while the cost of services has gone up.
As you can see Medicare does not cover all of your expenses. To cover the gaps in coverage people sign up for a Medicare Supplement Insurance Policy. These policies are standardized, meaning that Social Security sets what expenses each policy will cover. The policies are designated by letters A thru N, with each offering different coverage options. The details of each policy and what they cover maybe confusing, please allows us to help you decide which policy best suits your needs. Contact us at

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