Medicare Coverage Explained: What You Need to Know | Features


Whether you’re new to the Medicare program or have been enrolled for a while, navigating the system can be complicated. Parts of the program change every year and it can be hard to keep up. Please read ahead for information about this year’s changes (in bold) and a refresher on the basics.

M stands for multiple parts

Medical insurance has four parts, each with different functions. Part A (Hospital Insurance) covers hospital inpatient care, skilled nursing facility care, home health care, and hospice care. Part B (Medicare) covers services provided by health care providers, including doctors, outpatient care, home health care, medical equipment and preventive services. Part D (drug coverage) covers prescription drugs, including many vaccines. Original Medicare includes Parts A and B, and you can join a separate Medicare drug plan to get Part D coverage. Part C (Medicare Advantage) is a plan approved by a private company as an alternative to original Medicare coverage for health and drugs. Medicare Supplemental Insurance (Medigap) can be purchased additionally from private companies to help pay a share of Original Medicare costs.

E stands for eight percent

Those receiving Social Security will automatically receive a Medicare card three months before becoming eligible. Health insurance costs can also be helped through Supplemental Security Income, a social security program for low-income people. also, Social Security cost-of-living adjustment increases benefits by more than 8 percent this year (Not exactly a Medicare change, but still good news!). Part B premiums tend to be deducted directly from monthly Social Security payments, so people in both plans have more money in their pockets than they did last year. To receive Social Security, contact your local Social Security office or apply online at

D stands for deductible

Part B annual deductible reduced by $7 this year The price is now $226.The limit is The government-set Part D deductible has increased to $505 That compares to $480 last year. also, The deductible per hospitalization under Part A has been increased to $1,600 per stay, an increase of $44 from last year.

I for immunization

New this year, Vaccines recommended by the Centers for Disease Control for adults and the Advisory Committee on Preventive Immunization Practices. Prescription drug coverage is free for Medicare beneficiaries. Under Part B, vaccines for influenza, pneumonia, COVID-19 initial and booster shots and hepatitis B, as well as vaccines to treat injuries or exposures such as hepatitis A, rabies and tetanus, are already free. Part D prescription drug plans will now cover other vaccines, Most notable are two doses of Shingrix Prevent shingles. Starting this year, recommended vaccines will be provided free of charge to beneficiaries who previously required partial payment. This coverage occurs even if the Part D deductible is not met.

C stands for insulin upper limit

The Inflation Reduction Act of 2022 now achieves this goal The deductible for any thirty-day supply of insulin covered by the Medicare drug plan will be limited to thirty-five dollars, even before the Part D deductible is met. Enrollees who take insulin through a pump under Part B benefits do not pay a deductible and benefit from this deductible cap. Not all insulin is covered.

A stands for age

At age sixty-five, you automatically become eligible for Medicare and can enroll on the first day of your birthday month. You must be a U.S. citizen for at least five years when registering. Under certain circumstances, you can receive Medicare early; for example, if you receive Social Security Disability benefits or have a specific diagnosis. A licensed agent can help you determine this.

R for research

There are Medicare coverage options to suit everyone’s needs. Information sessions are sometimes held through local school districts or your health insurance company. There is also a wealth of information available online. Do your work, compare plans, talk to your health care provider and find what works for you. Remember, many people are trying to profit from the chaos, so well-informed customers usually get the best results.

E stands for expanded enrollment

Previously, if someone signed up for Medicare outside of a designated period (usually within three months of turning sixty-five), they could have to wait two to three months for it to take effect. This year, if you sign up during the official enrollment period, coverage will go into effect early next month. The special registration window has been expanded to include those who did not register when they first became eligible through no fault of their own. This includes people affected by natural disasters, misled by their employer, or who lost Medicaid coverage.

Visit for the latest information and to find the information most helpful for your unique situation.

Reagan Zuber Assistant Editor forever Young.

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