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Garner NC
United States 27529
FAQ
MEDICARE MADE EASY
Medicare Basics
Original Medicare includes Parts A and B. Part A covers inpatient hospital stays, skilled nursing, and a portion of hospice care. Part B covers physician and outpatient care. Both Part A and B are required to enroll in a Medicare Advantage plan or Medicare Supplement.
Part A will be no cost for someone turning 65 who has paid Medicare taxes for 40 quarters. Part B premium is $185 monthly in 2025.
In 2025, the Part B deductible is $257 per year. After meeting this deductible, you generally pay 20% of the Medicare-approved charges. For Part A, the inpatient hospital deductible is $1,676 per stay, covering the first 60 days. From days 61-90, the cost is $419 per day. Beyond 90 days, you pay $838 per "lifetime reserve day" for up to 60 days over your lifetime.
Medicare Part D is what pays prescription drugs. Usually drugs will be broken down into tears based on cost, generic, or brand. Part A OR part B is required to enroll in Part D. You do not have to have both to enroll in prescription Part D
Medicare Part C is also known as Medicare Advantage. Medicare Advantage plans are offered by private insurance companies and they pay a fixed fee for your care at doctors and hospitals in the plan’s approved network. Many times Part D is included in a Medicare Advantage plan, and additional benefits such as dental, vision and even health club memberships may be included. Premiums tend to be much lower than a Medicare Supplement plan.
In general, you can pick one of two options for Medicare coverage when you are turning 65, or if you currently have original Medicare (Part A+Part B)
1. Medicare Advantage or Medicare Part C (combines all parts of Medicare into one)
2. Medicare Supplement with a stand alone Medicare part D plan (prescription coverage)
See flow chart attached.
NC SENIOR SOLUTIONS
"Medicare simplified"
MEDICARE SUPPLEMENT
Medicare Supplement
A Medicare Supplement plan, also known as Medigap, helps cover some out-of-pocket costs not covered by Medicare Parts A and B, like deductibles and coinsurance. It's a private health insurance policy that fills in the gaps of Original Medicare.
You can apply for Medicare Supplement during open enrollment. Open enrollment includes a six-month period from the date you enrolled in Medicare Part B if age 65 or older, or up to six-month after you turn 65 if you were eligible for Part B benefits before age 65.
They may increase but sometimes they decrease. You cannot be singled out for a premium change. The company may change premiums as a whole once a year.
Not everyone needs a Medicare Supplement plan. If you have coverage through an employer group health plan or are enrolled in a Medicare Advantage plan, you might not need extra coverage. Remember, Medicare Supplement plans don't coordinate benefits with Medicare Advantage plans.
No, a Medicare Supplement plan does not cover prescription drugs. You will need to enroll in a separate Part D plan for that coverage.
Yes, with a Medicare Supplement plan, you can visit any licensed doctor who accepts Medicare. There are no network restrictions, giving you the freedom to choose your healthcare providers.
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