“I believe the most important aspect of Medicare is not the structure of the program but the guarantee to all Americans that they will have high quality health care as they get older.”
Ron Wyden
Enrolling in Medicare can be very confusing. Trying to understand what Medicare covers and what it doesn’t, along with how much this will cost you is overwhelming enough. Couple that with the available Medicare Advantage plans, Medicare Supplement plans, Part D Prescription plans and penalties for not signing up when first eligible, and many seniors will get thoroughly frustrated. This page is intended to give you a brief understanding of the Medicare system. It is not a complete synopsis and should not be considered a replacement for the Medicare Handbook (which you can download here ) or for obtaining professional advice from a licensed agent. Please request an appointment with a representative of Carter Jacobs for your personal consultation.

Medicare Part A - This covers hospital expenses and typically comes at no additional charge as most seniors have been paying into Medicare most of their working lives. There is a deductible and possibly co-insurance. Since the benefits come to you at no additional charge, most seniors should sign up for this even if they have existing coverage elsewhere. See this Part A Medicare Benefits chart for more information and costs.

Medicare Part B - This covers physician services, lab work and medical equipment. The monthly charge for this is typically $134 for those that are new to Medicare. There is an annual deductible along with co-insurance. It is essentially an 80/20 plan after the deductible where Medicare will pay 80% of the charges and the beneficiary will pay the 20%. See this Part B Medicare Benefits chart for more information and costs. There can also be penalties if you do not sign up when first eligible. Essentially, if you do not have qualifying health insurance elsewhere, then you are expected to be on Medicare. Please contact us for more details on this.

Medicare Part C - These are the Medicare Advantage plans. An Advantage plan completely replaces Original Medicare (Parts A&B) and has Medicare administered through an independent insurance company. Medicare requires that the benefits of a Medicare Advantage plan be as good or better than Original Medicare. Most of the time (but not always) Medicare Advantage plans will also include your Part D prescription drug plans. Many seniors will confuse a Medicare Advantage plan with a Medicare Supplement, that is very easy to do. However, they are vastly different and you can read about those differences here.

Medicare Part D - This is the prescription drug plan. These are administered by independent insurance companies and the monthly premiums will vary. Penalties can also be assessed here if Part D is not obtained when you are first eligible, unless you have qualifying coverage elsewhere. Along with the monthly premium, each plan will have different charges for the individual medications depending upon which drug tier it is in. Additionally, some companies will not cover particular medications. It is imperative that you have an advisor run your specific prescriptions to make sure your prescription are covered and the costs are as low as possible.

Medicare Supplement Plans - These plans are also known as Medigap plans and they supplement (or fill in the gaps of) Original Medicare. The plans are standardized (by plan letter) by state and federal laws. This makes comparing prices easy since plans with the same letter must offer the same benefits with every insurance carrier. You can check out this Medicare Supplements Comparison  chart for more information on three of the most popular plans.