{"id":531,"date":"2024-02-01T17:28:56","date_gmt":"2024-02-02T01:28:56","guid":{"rendered":"https:\/\/medisure.agency\/articles\/?p=531"},"modified":"2024-02-28T09:37:32","modified_gmt":"2024-02-28T17:37:32","slug":"a-comprehensive-overview-of-medicare","status":"publish","type":"post","link":"https:\/\/medisure.agency\/articles\/2024\/02\/01\/a-comprehensive-overview-of-medicare\/","title":{"rendered":"What is Medicare: 2024"},"content":{"rendered":"<h2><span style=\"font-size: 12pt;\">Introduction to Medicare:<\/span><\/h2>\r\n<p><span style=\"font-size: 12pt;\">Medicare is a federally funded health insurance program.&nbsp; It caters primarily to those aged 65 and older.&nbsp; It also covers younger individuals with disabilities or specific medical conditions. Medicare is funded through a combination of payroll taxes, premiums paid by beneficiaries, and general revenues.<\/span><\/p>\r\n<p><span style=\"font-size: 12pt;\">The funding sources are described as follows:<\/span><\/p>\r\n<ol>\r\n<li><span style=\"font-size: 12pt;\"><strong>Payroll Taxes:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">The largest source of funding comes from payroll taxes. These taxes are deducted from the paychecks of working individuals and are divided into two parts:<\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">The parts are the <a href=\"https:\/\/www.cbo.gov\/budget-options\/54804\">Hospital Insurance (HI) payroll tax<\/a> and the <a href=\"https:\/\/www.taxpolicycenter.org\/briefing-book\/what-medicare-trust-fund-and-how-it-financed\">Supplementary Medical Insurance (SMI) payroll tax<\/a>. The <a href=\"https:\/\/www.taxpolicycenter.org\/briefing-book\/what-medicare-trust-fund-and-how-it-financed\">Hospital Insurance (HI) payroll tax<\/a> is also known as the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> tax. It is a 2.9% tax on earnings, with 1.45% paid by both employees and employers. For individuals with higher incomes, an additional 0.9% may apply.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Premiums from Beneficiaries:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Beneficiaries enrolled in certain parts of Medicare may be required to pay premiums. The main components are:<\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><strong><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> Premiums: <\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Beneficiaries pay a monthly <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Premium&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An insurance premium is the amount of money you pay for an insurance policy. It is the price of getting coverage from an insurance company. You can pay the premium monthly, quarterly, semiannually, or annually, depending on the policy. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/premium\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">premium<\/a> for Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> (Medical Insurance), which covers <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Outpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An outpatient is an individual who receives medical care from a hospital or clinic without staying overnight. Outpatient care encompasses routine exams, minor surgeries, lab tests, imaging, and consultations with specialists. It differs from inpatient care, which involves hospitalization for more than one night. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/outpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">outpatient<\/a> services, doctor visits, and other medically necessary services.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> Premiums: <\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Beneficiaries who opt for prescription drug coverage under Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> pay premiums to private insurance companies offering these plans.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> <a href=\"https:\/\/medisure.agency\/articles\/glossary\/premium\/\">Premiums<\/a>: <\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Beneficiaries enrolled in <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> plans (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part C<\/a>) may pay premiums. It depends on the specific plan and the additional benefits it offers.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>General Revenues:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">In addition to payroll taxes and premiums, Medicare is funded through general revenues from the federal government. These revenues come from income taxes, corporate taxes, and other sources. General revenues help cover the costs of Medicare, particularly the Supplementary Medical Insurance (SMI) program, which includes Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> and <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a>.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Other Sources:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Medicare also receives funding from other sources, such as interest earned on the Medicare Trust Fund&rsquo;s investments.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ol>\r\n<h2><span style=\"font-size: 12pt;\">Medicare 2024 <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> (Hospital Insurance):<\/span><\/h2>\r\n<p><span style=\"font-size: 12pt;\">Covers <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Inpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An inpatient is an individual admitted to a hospital, undergoing medical care and treatment for more than one night. The person might need surgery or other procedures that necessitate close monitoring. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/inpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">inpatient<\/a> hospital stays, skilled nursing facility care, <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Hospice care&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Hospice care is a kind of health care that concentrates on offering comfort and support to individuals with a terminal illness, expect to live less than six months. Instead of aiming for a cure, hospice care focuses on easing pain and symptoms to enhance the patient&amp;#039;s and their family&amp;#039;s quality of life. It can be provided at home, in a hospital, in a nursing home, or in a hospice facility. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/hospice-care\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">hospice care<\/a>, and some <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Home Health Care&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Home health care is when you get medical or non-medical help at your home for an illness or injury. It includes things like medical care for wounds or therapy, and also assistance with daily activities or keeping your home in order. The goal is to help you get better, be more independent, or maintain your current health. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/home-health-care\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">home health care<\/a> services. Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> consists of the following:<\/span><\/p>\r\n<h3><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Premium&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An insurance premium is the amount of money you pay for an insurance policy. It is the price of getting coverage from an insurance company. You can pay the premium monthly, quarterly, semiannually, or annually, depending on the policy. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/premium\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Premium<\/a><\/span><\/h3>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">$0 for most people (because they or a spouse paid Medicare taxes long enough while working &ndash; generally at least 10 years). This is sometimes called &ldquo;premium-free <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a>.&rdquo;<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">If you do not qualify for premium-free <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a>: You might be able to buy it. You will pay either $278 (2024) or $505 (2024) each month for <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a>, depending on how long you or your spouse worked and paid Medicare taxes.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Remember:<\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">You also must sign up for <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> to buy <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a>.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">If you do not buy <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> when you are first eligible for Medicare (usually when you turn 65), you might pay a penalty.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h3><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Deductible&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; &amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;An insurance deductible is the amount of money that you have to pay for certain types of claims before your insurance company will cover the rest.&nbsp;&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;Different types of insurance have different ways of applying them. Some are per claim, meaning you have to pay them each time you file a claim. Some are per year, meaning you only have to pay them once in a calendar year. Some deductibles are fixed amounts, while some are percentages of the total claim amount.&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;The size affects the cost of your insurance premium. Generally, the higher your deductible, the lower your premium, and vice versa. This is because you are taking on more or less risk by choosing a higher or lower deductible. You should choose a deductible that you can afford to pay in case of a claim, but also that suits your budget and needs.&amp;lt;\/span&amp;gt; &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/deductible\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Deductible<\/a><\/span><\/h3>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">$1,632 for each <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Inpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An inpatient is an individual admitted to a hospital, undergoing medical care and treatment for more than one night. The person might need surgery or other procedures that necessitate close monitoring. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/inpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">inpatient<\/a> hospital <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Benefit period&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A benefit period is a specific time frame during which certain hospital and skilled nursing facility services are covered under Medicare Part A. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/benefit-period\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">benefit period<\/a>, before <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Original Medicare&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare refers to the traditional fee-for-service health insurance program offered by the federal government in the United States. It includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/original-medicare\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Original Medicare<\/a> starts to pay.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">There is no limit to the number of benefit periods you can have in a year. This means you may pay the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Deductible&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; &amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;An insurance deductible is the amount of money that you have to pay for certain types of claims before your insurance company will cover the rest.&nbsp;&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;Different types of insurance have different ways of applying them. Some are per claim, meaning you have to pay them each time you file a claim. Some are per year, meaning you only have to pay them once in a calendar year. Some deductibles are fixed amounts, while some are percentages of the total claim amount.&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;The size affects the cost of your insurance premium. Generally, the higher your deductible, the lower your premium, and vice versa. This is because you are taking on more or less risk by choosing a higher or lower deductible. You should choose a deductible that you can afford to pay in case of a claim, but also that suits your budget and needs.&amp;lt;\/span&amp;gt; &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/deductible\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">deductible<\/a> more than once a year.<\/span><\/li>\r\n<\/ul>\r\n<h3><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Inpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An inpatient is an individual admitted to a hospital, undergoing medical care and treatment for more than one night. The person might need surgery or other procedures that necessitate close monitoring. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/inpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Inpatient<\/a> stay<\/span><\/h3>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Days 1-60: $0 after you pay your <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Deductible&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; &amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;An insurance deductible is the amount of money that you have to pay for certain types of claims before your insurance company will cover the rest.&nbsp;&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;Different types of insurance have different ways of applying them. Some are per claim, meaning you have to pay them each time you file a claim. Some are per year, meaning you only have to pay them once in a calendar year. Some deductibles are fixed amounts, while some are percentages of the total claim amount.&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;The size affects the cost of your insurance premium. Generally, the higher your deductible, the lower your premium, and vice versa. This is because you are taking on more or less risk by choosing a higher or lower deductible. You should choose a deductible that you can afford to pay in case of a claim, but also that suits your budget and needs.&amp;lt;\/span&amp;gt; &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/deductible\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">deductible<\/a>.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Days 61-90: $400 ($408 in 2024) <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Copayment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A copayment, often referred to as a copay, is a fixed amount of money that an insured person pays for covered healthcare services, usually at the time of receiving the service. This payment is a predetermined, out-of-pocket expense that helps share the costs of the healthcare service between the insurance provider and the insured individual. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/copayment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">copayment<\/a> each day.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Days 91-150: $800 ($816 in 2024) <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Copayment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A copayment, often referred to as a copay, is a fixed amount of money that an insured person pays for covered healthcare services, usually at the time of receiving the service. This payment is a predetermined, out-of-pocket expense that helps share the costs of the healthcare service between the insurance provider and the insured individual. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/copayment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">copayment<\/a> each day while using your 60 lifetime reserve days.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">After day 150: You pay all costs.<\/span><\/li>\r\n<\/ul>\r\n<h3><span style=\"font-size: 12pt;\">Skilled nursing facility stay<\/span><\/h3>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Days 1-20: $0 <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Copayment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A copayment, often referred to as a copay, is a fixed amount of money that an insured person pays for covered healthcare services, usually at the time of receiving the service. This payment is a predetermined, out-of-pocket expense that helps share the costs of the healthcare service between the insurance provider and the insured individual. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/copayment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">copayment<\/a><\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Days 21-100: $200 ($204 in 2024) <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Copayment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A copayment, often referred to as a copay, is a fixed amount of money that an insured person pays for covered healthcare services, usually at the time of receiving the service. This payment is a predetermined, out-of-pocket expense that helps share the costs of the healthcare service between the insurance provider and the insured individual. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/copayment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">copayment<\/a> each day.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Days 101 and beyond: You pay all costs.<\/span><\/li>\r\n<\/ul>\r\n<h3><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Home Health Care&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Home health care is when you get medical or non-medical help at your home for an illness or injury. It includes things like medical care for wounds or therapy, and also assistance with daily activities or keeping your home in order. The goal is to help you get better, be more independent, or maintain your current health. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/home-health-care\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Home health care<\/a><\/span><\/h3>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">$0 for covered <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Home Health Care&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Home health care is when you get medical or non-medical help at your home for an illness or injury. It includes things like medical care for wounds or therapy, and also assistance with daily activities or keeping your home in order. The goal is to help you get better, be more independent, or maintain your current health. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/home-health-care\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">home health care<\/a> services.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">20% of the Medicare-approved amount for <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;DME&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Durable Medical Equipment (DME) refers to medical equipment and supplies that are designed for repeated use and are appropriate for use in the home. These items provide therapeutic benefits or support individuals with medical conditions or disabilities. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/dme\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">durable medical equipment<\/a> (like wheelchairs, walkers, hospital beds, and other equipment).<\/span><\/li>\r\n<\/ul>\r\n<h3><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Hospice care&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Hospice care is a kind of health care that concentrates on offering comfort and support to individuals with a terminal illness, expect to live less than six months. Instead of aiming for a cure, hospice care focuses on easing pain and symptoms to enhance the patient&amp;#039;s and their family&amp;#039;s quality of life. It can be provided at home, in a hospital, in a nursing home, or in a hospice facility. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/hospice-care\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Hospice care<\/a><\/span><\/h3>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">$0 for covered <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Hospice care&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Hospice care is a kind of health care that concentrates on offering comfort and support to individuals with a terminal illness, expect to live less than six months. Instead of aiming for a cure, hospice care focuses on easing pain and symptoms to enhance the patient&amp;#039;s and their family&amp;#039;s quality of life. It can be provided at home, in a hospital, in a nursing home, or in a hospice facility. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/hospice-care\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">hospice care<\/a> service.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">You may also pay:<\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">A <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Copayment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A copayment, often referred to as a copay, is a fixed amount of money that an insured person pays for covered healthcare services, usually at the time of receiving the service. This payment is a predetermined, out-of-pocket expense that helps share the costs of the healthcare service between the insurance provider and the insured individual. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/copayment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">copayment<\/a> of up to $5 for each prescription drug and other similar products for pain relief and symptom control while you are at home.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">5% of the Medicare-approved amount for <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Inpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An inpatient is an individual admitted to a hospital, undergoing medical care and treatment for more than one night. The person might need surgery or other procedures that necessitate close monitoring. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/inpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">inpatient<\/a> respite care.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h2><span style=\"font-size: 12pt;\">Medicare 2024 <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> (Medical Insurance):<\/span><\/h2>\r\n<h3><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> Costs<\/span><\/h3>\r\n<p><span style=\"font-size: 12pt;\">Covers <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Outpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An outpatient is an individual who receives medical care from a hospital or clinic without staying overnight. Outpatient care encompasses routine exams, minor surgeries, lab tests, imaging, and consultations with specialists. It differs from inpatient care, which involves hospitalization for more than one night. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/outpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">outpatient<\/a> care, preventive services, doctor visits, and other necessary services. Requires a monthly <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Premium&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An insurance premium is the amount of money you pay for an insurance policy. It is the price of getting coverage from an insurance company. You can pay the premium monthly, quarterly, semiannually, or annually, depending on the policy. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/premium\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">premium<\/a> payment, with specific enrollment periods.&nbsp; Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> costs consist of the following:<\/span><\/p>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><strong><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Premium&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An insurance premium is the amount of money you pay for an insurance policy. It is the price of getting coverage from an insurance company. You can pay the premium monthly, quarterly, semiannually, or annually, depending on the policy. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/premium\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Premium<\/a> <\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">$174.70 each month (or higher depending on your income). The amount can change each year. You will pay the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Premium&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An insurance premium is the amount of money you pay for an insurance policy. It is the price of getting coverage from an insurance company. You can pay the premium monthly, quarterly, semiannually, or annually, depending on the policy. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/premium\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">premium<\/a> each month, even if you do not get any Part B-covered services. You might pay a monthly penalty if you do not sign up for <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> when you are first eligible for Medicare (usually when you turn 65). You will pay the penalty for as long as you have <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a>. The penalty goes up the longer you wait to sign up.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Deductible&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; &amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;An insurance deductible is the amount of money that you have to pay for certain types of claims before your insurance company will cover the rest.&nbsp;&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;Different types of insurance have different ways of applying them. Some are per claim, meaning you have to pay them each time you file a claim. Some are per year, meaning you only have to pay them once in a calendar year. Some deductibles are fixed amounts, while some are percentages of the total claim amount.&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;The size affects the cost of your insurance premium. Generally, the higher your deductible, the lower your premium, and vice versa. This is because you are taking on more or less risk by choosing a higher or lower deductible. You should choose a deductible that you can afford to pay in case of a claim, but also that suits your budget and needs.&amp;lt;\/span&amp;gt; &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/deductible\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Deductible<\/a> <\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">The Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Deductible&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; &amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;An insurance deductible is the amount of money that you have to pay for certain types of claims before your insurance company will cover the rest.&nbsp;&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;Different types of insurance have different ways of applying them. Some are per claim, meaning you have to pay them each time you file a claim. Some are per year, meaning you only have to pay them once in a calendar year. Some deductibles are fixed amounts, while some are percentages of the total claim amount.&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;The size affects the cost of your insurance premium. Generally, the higher your deductible, the lower your premium, and vice versa. This is because you are taking on more or less risk by choosing a higher or lower deductible. You should choose a deductible that you can afford to pay in case of a claim, but also that suits your budget and needs.&amp;lt;\/span&amp;gt; &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/deductible\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">deductible<\/a> for 2024 is $240.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">You must pay $240 before <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Original Medicare&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare refers to the traditional fee-for-service health insurance program offered by the federal government in the United States. It includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/original-medicare\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Original Medicare<\/a> starts to pay. You pay this <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Deductible&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; &amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;An insurance deductible is the amount of money that you have to pay for certain types of claims before your insurance company will cover the rest.&nbsp;&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;Different types of insurance have different ways of applying them. Some are per claim, meaning you have to pay them each time you file a claim. Some are per year, meaning you only have to pay them once in a calendar year. Some deductibles are fixed amounts, while some are percentages of the total claim amount.&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;The size affects the cost of your insurance premium. Generally, the higher your deductible, the lower your premium, and vice versa. This is because you are taking on more or less risk by choosing a higher or lower deductible. You should choose a deductible that you can afford to pay in case of a claim, but also that suits your budget and needs.&amp;lt;\/span&amp;gt; &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/deductible\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">deductible<\/a> once each year.&nbsp;&nbsp;<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>General costs for services (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Coinsurance&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Coinsurance is a cost-sharing arrangement between an individual and their health insurance provider.&nbsp; Both parties share the costs of covered healthcare services after the individual has met their deductible. It is usually expressed as a percentage. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/coinsurance\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">coinsurance<\/a>) <\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Usually, 20% of the cost for each Medicare-covered service or item after you have paid your <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Deductible&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; &amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;An insurance deductible is the amount of money that you have to pay for certain types of claims before your insurance company will cover the rest.&nbsp;&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;Different types of insurance have different ways of applying them. Some are per claim, meaning you have to pay them each time you file a claim. Some are per year, meaning you only have to pay them once in a calendar year. Some deductibles are fixed amounts, while some are percentages of the total claim amount.&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;The size affects the cost of your insurance premium. Generally, the higher your deductible, the lower your premium, and vice versa. This is because you are taking on more or less risk by choosing a higher or lower deductible. You should choose a deductible that you can afford to pay in case of a claim, but also that suits your budget and needs.&amp;lt;\/span&amp;gt; &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/deductible\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">deductible<\/a>.&nbsp; &nbsp;If your doctor or health care provider accepts the Medicare-approved amount as full payment, it is called &ldquo;accepting <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Assignment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare assignment refers to an agreement that healthcare providers can enter into with Medicare. When a healthcare provider accepts Medicare assignment, it means they agree to accept the Medicare-approved amount as the full payment for covered services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/assignment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">assignment<\/a>&rdquo;.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">If your doctor does not &ldquo;accept <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Assignment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare assignment refers to an agreement that healthcare providers can enter into with Medicare. When a healthcare provider accepts Medicare assignment, it means they agree to accept the Medicare-approved amount as the full payment for covered services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/assignment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">assignment<\/a>&rdquo;, it means that they have not agreed to accept Medicare&rsquo;s approved amount as the full payment for their services.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">This means that they can charge you up to 15% more than the Medicare-approved amount.&nbsp; You may have to pay the difference out of your pocket.&nbsp;<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\"><a href=\"https:\/\/www.verywellhealth.com\/medicare-assignment-5323769\">You may also have to pay the entire bill upfront and seek reimbursement later.<\/a><\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Clinical laboratory services&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Clinical laboratory services are healthcare services where samples like blood or urine are tested to diagnose, monitor, or treat different diseases and conditions. These services cover a wide range of tests for infections, cancers, genetic disorders, drug levels, hormones, and other biomarkers. Trained professionals, such as clinical laboratory scientists, medical technologists, or pathologists, use specialized equipment and techniques to analyze these samples. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/clinical-laboratory-services\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Clinical laboratory services<\/a> <\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">$0 for covered <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Clinical laboratory services&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Clinical laboratory services are healthcare services where samples like blood or urine are tested to diagnose, monitor, or treat different diseases and conditions. These services cover a wide range of tests for infections, cancers, genetic disorders, drug levels, hormones, and other biomarkers. Trained professionals, such as clinical laboratory scientists, medical technologists, or pathologists, use specialized equipment and techniques to analyze these samples. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/clinical-laboratory-services\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">clinical laboratory services<\/a>.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Home Health Care&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Home health care is when you get medical or non-medical help at your home for an illness or injury. It includes things like medical care for wounds or therapy, and also assistance with daily activities or keeping your home in order. The goal is to help you get better, be more independent, or maintain your current health. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/home-health-care\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Home health care<\/a> <\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">$0 for covered <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Home Health Care&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Home health care is when you get medical or non-medical help at your home for an illness or injury. It includes things like medical care for wounds or therapy, and also assistance with daily activities or keeping your home in order. The goal is to help you get better, be more independent, or maintain your current health. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/home-health-care\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">home health care<\/a> services. 20% of the Medicare-approved amount for <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;DME&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Durable Medical Equipment (DME) refers to medical equipment and supplies that are designed for repeated use and are appropriate for use in the home. These items provide therapeutic benefits or support individuals with medical conditions or disabilities. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/dme\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">durable medical equipment<\/a> (like wheelchairs, walkers, hospital beds, and other equipment).<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Inpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An inpatient is an individual admitted to a hospital, undergoing medical care and treatment for more than one night. The person might need surgery or other procedures that necessitate close monitoring. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/inpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Inpatient<\/a> hospital care <\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">20% of the Medicare-approved amount for most doctor services while you are a hospital <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Inpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An inpatient is an individual admitted to a hospital, undergoing medical care and treatment for more than one night. The person might need surgery or other procedures that necessitate close monitoring. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/inpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">inpatient<\/a>.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Outpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An outpatient is an individual who receives medical care from a hospital or clinic without staying overnight. Outpatient care encompasses routine exams, minor surgeries, lab tests, imaging, and consultations with specialists. It differs from inpatient care, which involves hospitalization for more than one night. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/outpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Outpatient<\/a> mental health care <\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">$0 for your yearly depression screening.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">20% of the Medicare-approved amount for visits to your doctor or other health care provider to diagnose or treat your condition.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<ul>\r\n<li style=\"list-style-type: none;\">\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">If you get your services in a hospital <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Outpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An outpatient is an individual who receives medical care from a hospital or clinic without staying overnight. Outpatient care encompasses routine exams, minor surgeries, lab tests, imaging, and consultations with specialists. It differs from inpatient care, which involves hospitalization for more than one night. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/outpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">outpatient<\/a> clinic or hospital <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Outpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An outpatient is an individual who receives medical care from a hospital or clinic without staying overnight. Outpatient care encompasses routine exams, minor surgeries, lab tests, imaging, and consultations with specialists. It differs from inpatient care, which involves hospitalization for more than one night. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/outpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">outpatient<\/a> department, you may have to pay an additional amount to the hospital.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Partial hospitalization mental health care <\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">After you meet the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Deductible&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; &amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;An insurance deductible is the amount of money that you have to pay for certain types of claims before your insurance company will cover the rest.&nbsp;&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;Different types of insurance have different ways of applying them. Some are per claim, meaning you have to pay them each time you file a claim. Some are per year, meaning you only have to pay them once in a calendar year. Some deductibles are fixed amounts, while some are percentages of the total claim amount.&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;The size affects the cost of your insurance premium. Generally, the higher your deductible, the lower your premium, and vice versa. This is because you are taking on more or less risk by choosing a higher or lower deductible. You should choose a deductible that you can afford to pay in case of a claim, but also that suits your budget and needs.&amp;lt;\/span&amp;gt; &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/deductible\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">deductible<\/a>:<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">20% of the Medicare-approved amount for each service you get from a doctor or certain other qualified mental health professional.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Coinsurance&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Coinsurance is a cost-sharing arrangement between an individual and their health insurance provider.&nbsp; Both parties share the costs of covered healthcare services after the individual has met their deductible. It is usually expressed as a percentage. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/coinsurance\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Coinsurance<\/a> for each day of partial hospitalization services you get in a hospital <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Outpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An outpatient is an individual who receives medical care from a hospital or clinic without staying overnight. Outpatient care encompasses routine exams, minor surgeries, lab tests, imaging, and consultations with specialists. It differs from inpatient care, which involves hospitalization for more than one night. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/outpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">outpatient<\/a> setting or community mental health center.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Outpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An outpatient is an individual who receives medical care from a hospital or clinic without staying overnight. Outpatient care encompasses routine exams, minor surgeries, lab tests, imaging, and consultations with specialists. It differs from inpatient care, which involves hospitalization for more than one night. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/outpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Outpatient<\/a> hospital care<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Usually, 20% of the Medicare-approved amount is for doctors and other healthcare providers&rsquo; services.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">You will also pay a <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Copayment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A copayment, often referred to as a copay, is a fixed amount of money that an insured person pays for covered healthcare services, usually at the time of receiving the service. This payment is a predetermined, out-of-pocket expense that helps share the costs of the healthcare service between the insurance provider and the insured individual. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/copayment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">copayment<\/a> to the hospital for each service you get in a hospital <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Outpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An outpatient is an individual who receives medical care from a hospital or clinic without staying overnight. Outpatient care encompasses routine exams, minor surgeries, lab tests, imaging, and consultations with specialists. It differs from inpatient care, which involves hospitalization for more than one night. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/outpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">outpatient<\/a> setting (except for certain preventive services). In most cases, your <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Copayment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A copayment, often referred to as a copay, is a fixed amount of money that an insured person pays for covered healthcare services, usually at the time of receiving the service. This payment is a predetermined, out-of-pocket expense that helps share the costs of the healthcare service between the insurance provider and the insured individual. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/copayment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">copayment<\/a> will not be more than the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> hospital stay <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Deductible&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; &amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;An insurance deductible is the amount of money that you have to pay for certain types of claims before your insurance company will cover the rest.&nbsp;&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;Different types of insurance have different ways of applying them. Some are per claim, meaning you have to pay them each time you file a claim. Some are per year, meaning you only have to pay them once in a calendar year. Some deductibles are fixed amounts, while some are percentages of the total claim amount.&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;The size affects the cost of your insurance premium. Generally, the higher your deductible, the lower your premium, and vice versa. This is because you are taking on more or less risk by choosing a higher or lower deductible. You should choose a deductible that you can afford to pay in case of a claim, but also that suits your budget and needs.&amp;lt;\/span&amp;gt; &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/deductible\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">deductible<\/a> amount. This additional hospital <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Copayment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A copayment, often referred to as a copay, is a fixed amount of money that an insured person pays for covered healthcare services, usually at the time of receiving the service. This payment is a predetermined, out-of-pocket expense that helps share the costs of the healthcare service between the insurance provider and the insured individual. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/copayment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">copayment<\/a> means you may pay more for an <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Outpatient&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An outpatient is an individual who receives medical care from a hospital or clinic without staying overnight. Outpatient care encompasses routine exams, minor surgeries, lab tests, imaging, and consultations with specialists. It differs from inpatient care, which involves hospitalization for more than one night. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/outpatient\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">outpatient<\/a> service you get in a hospital than you would pay if you got the same service in a doctor&rsquo;s office.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h3><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> Preventive Services<\/span><\/h3>\r\n<p><span style=\"font-size: 12pt;\">A key feature of Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> is the fact that it provides a set of preventive care services at no additional costs.&nbsp; The preventive services are as follows:<\/span><\/p>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><a href=\"https:\/\/medisure.agency\/articles\/2024\/01\/24\/unlocking-the-benefits-of-medicares-annual-wellness-visits\/\">Annual &ldquo;Wellness&rdquo;<\/a> visits to assess your health and develop a personalized prevention plan.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Vaccinations for influenza (flu), pneumonia, hepatitis B, <a href=\"https:\/\/medisure.agency\/articles\/2024\/02\/04\/understanding-respiratory-syncytial-virus-rsv\/\"><\/a><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;RSV&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; RSV stands for respiratory syncytial virus, a common respiratory virus that usually causes mild, cold-like symptoms, such as runny nose, cough, and fever. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/rsv\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">RSV<\/a>, and COVID-19.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Screenings for conditions like cardiovascular disease, diabetes, depression, HIV, and lung cancer.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Counseling sessions for alcohol misuse, obesity, tobacco use, and sexually transmitted infections.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Programs for health education and monitoring, such as the Medicare Diabetes Prevention Program and nutrition therapy services.<\/span><\/li>\r\n<\/ul>\r\n<p><span style=\"font-size: 12pt;\">You can access a comprehensive list of preventive and screening services covered by Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> on <a href=\"https:\/\/www.medicare.gov\/\">Medicare.gov<\/a> or in the booklet <a href=\"https:\/\/www.medicare.gov\/publications\/10110-Your-Guide-to-Medicare-Preventive-Services.pdf\">&ldquo;Your Guide to Medicare&rsquo;s Preventive Services.&rdquo;<\/a><\/span><\/p>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;DME&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Durable Medical Equipment (DME) refers to medical equipment and supplies that are designed for repeated use and are appropriate for use in the home. These items provide therapeutic benefits or support individuals with medical conditions or disabilities. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/dme\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Durable Medical Equipment<\/a><\/span><\/li>\r\n<\/ul>\r\n<p><span style=\"font-size: 12pt;\">Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> will cover <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;DME&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Durable Medical Equipment (DME) refers to medical equipment and supplies that are designed for repeated use and are appropriate for use in the home. These items provide therapeutic benefits or support individuals with medical conditions or disabilities. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/dme\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">durable medical equipment<\/a> (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;DME&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Durable Medical Equipment (DME) refers to medical equipment and supplies that are designed for repeated use and are appropriate for use in the home. These items provide therapeutic benefits or support individuals with medical conditions or disabilities. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/dme\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">DME<\/a>) if your Medicare-enrolled doctor or other healthcare provider prescribes it for use in your home. <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;DME&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Durable Medical Equipment (DME) refers to medical equipment and supplies that are designed for repeated use and are appropriate for use in the home. These items provide therapeutic benefits or support individuals with medical conditions or disabilities. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/dme\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">DME<\/a> covered by Medicare includes, but is not limited to:<\/span><\/p>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Blood sugar meters<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Blood sugar test strips<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Canes<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Commode chairs<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Continuous passive motion machines, devices, and accessories<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Continuous Positive Airway Pressure (CPAP) machines<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Crutches<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Home infusion services<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Hospital beds<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Infusion pumps and supplies<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Lancet devices and lancets<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Nebulizers and nebulizer medications<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Oxygen equipment and accessories<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Patient lifts<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Pressure-reducing support surfaces<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Suction pumps<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Traction equipment<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Walkers<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">Wheelchairs and scooters<\/span><\/li>\r\n<\/ul>\r\n<p><span style=\"font-size: 12pt;\">Many of the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;DME&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Durable Medical Equipment (DME) refers to medical equipment and supplies that are designed for repeated use and are appropriate for use in the home. These items provide therapeutic benefits or support individuals with medical conditions or disabilities. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/dme\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">DME<\/a> equipment will support the emerging trends of <a href=\"https:\/\/medisure.agency\/articles\/2024\/01\/21\/the-rise-of-at-home-diagnostics\/\">at-home diagnostics<\/a>.<\/span><\/p>\r\n<h2><span style=\"font-size: 12pt;\"><strong>Medicare 2024 <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part C<\/a> (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a>):<\/strong><\/span><\/h2>\r\n<p><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a>, also known as Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part C<\/a>, is an alternative way for beneficiaries to receive their Medicare benefits. Rather than receiving <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Original Medicare&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare refers to the traditional fee-for-service health insurance program offered by the federal government in the United States. It includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/original-medicare\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Original Medicare<\/a> (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> and <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a>) directly from the federal government, individuals can opt for <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> plans, which are offered by private insurance companies approved by the Medicare program. Here are key points about <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a>:<\/span><\/p>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><strong>Combination of Coverage:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> plans combine the benefits of Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> (hospital insurance) and <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> (medical insurance) into a single plan. Many <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> plans also include additional coverage, such as vision, dental, and prescription drug coverage (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a>).<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Private Insurance Companies:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Unlike <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Original Medicare&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare refers to the traditional fee-for-service health insurance program offered by the federal government in the United States. It includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/original-medicare\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Original Medicare<\/a>, which is administered by the federal government, <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> plans are offered by private insurance companies that are approved by Medicare. These plans must provide at least the same level of coverage as <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Original Medicare&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare refers to the traditional fee-for-service health insurance program offered by the federal government in the United States. It includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/original-medicare\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Original Medicare<\/a>.&nbsp;&nbsp;<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Different Plan Types:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">There are different types of <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;FFS&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; FFS stands for Fee-for-Service, which is a traditional healthcare payment model where healthcare providers are paid for each service they deliver. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/ffs\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Fee-for-Service<\/a> (PFFS) plans, Special Needs Plans (SNPs), and more. Each plan type has its network of healthcare providers and specific rules for how services are covered.&nbsp; Generally, these plans are managed care plans.&nbsp; Costs are controlled by restricting or favoring beneficiaries using in-network providers.&nbsp; Additionally, many of these plan types require <a href=\"https:\/\/medisure.agency\/articles\/2024\/01\/28\/breaking-barriers-the-evolution-of-prior-authorization-rules\/\"><\/a><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Prior authorizations&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Prior authorization is a process used by health insurance companies to determine whether they will cover and pay for certain medical services, procedures, medications, or durable medical equipment before they are provided or prescribed. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/prior-authorization\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">prior approval<\/a> from your <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;PCP&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; PCP stands for Primary Care Physician, which is a healthcare provider who serves as the main point of contact for an individual&amp;#039;s overall healthcare needs. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/pcp\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">primary care physician<\/a> before you can see a specialist.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Costs and Premiums:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">While Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> is generally premium-free for most eligible individuals, <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> plans may have monthly premiums in addition to the standard <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Premium&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An insurance premium is the amount of money you pay for an insurance policy. It is the price of getting coverage from an insurance company. You can pay the premium monthly, quarterly, semiannually, or annually, depending on the policy. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/premium\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">premium<\/a>. Some plans may offer low or $0 premiums, but individuals still need to pay their <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Premium&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An insurance premium is the amount of money you pay for an insurance policy. It is the price of getting coverage from an insurance company. You can pay the premium monthly, quarterly, semiannually, or annually, depending on the policy. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/premium\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">premium<\/a>.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Out-of-Pocket Costs:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> plans have out-of-pocket costs, including deductibles, copayments, and <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Coinsurance&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Coinsurance is a cost-sharing arrangement between an individual and their health insurance provider.&nbsp; Both parties share the costs of covered healthcare services after the individual has met their deductible. It is usually expressed as a percentage. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/coinsurance\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">coinsurance<\/a>. These costs can vary between plans, and some plans may have annual limits on out-of-pocket spending.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Network Restrictions:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Depending on the plan type, individuals may need to use healthcare providers within the plan&rsquo;s network. Some plans require referrals to see specialists, while others allow direct access.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Enrollment Period:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Beneficiaries can enroll in or make changes to their <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> plans during the Annual Enrollment Period (AEP), which typically runs from October 15 to December 7 each year.&nbsp; There is also a &ldquo;<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> <a href=\"https:\/\/medisure.agency\/articles\/2024\/01\/15\/navigating-the-medicare-advantage-open-enrollment-period-a-comprehensive-guide\/\">Open Enrollment Period<\/a>&rdquo; that runs from January 1st until March 31st.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<p><span style=\"font-size: 12pt;\">It&rsquo;s important for individuals considering <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> to carefully review the specific details of each plan, including coverage, costs, and network restrictions, to choose a plan that best meets their healthcare needs.<\/span><\/p>\r\n<h2><span style=\"font-size: 12pt;\"><strong>Medicare 2024 <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> (Prescription Drug Coverage): <\/strong><\/span><\/h2>\r\n<p><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> is a prescription drug coverage program.&nbsp; It is offered by private insurance companies.&nbsp; &nbsp;Medicare must approve these plans. It is designed to help Medicare beneficiaries afford the costs of prescription medications. Here are key points about Medicare <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a>:<\/span><\/p>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><strong>Voluntary Prescription Drug Coverage:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> is a voluntary program. Beneficiaries have the option to enroll in a standalone <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;PDP&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A PDP is a standalone Medicare Part D plan that provides coverage specifically for outpatient prescription drugs. These plans are offered by private insurance companies that are approved by Medicare. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/pdp\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Prescription Drug Plan<\/a> (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;PDP&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A PDP is a standalone Medicare Part D plan that provides coverage specifically for outpatient prescription drugs. These plans are offered by private insurance companies that are approved by Medicare. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/pdp\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">PDP<\/a>) or choose a <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> plan (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part C<\/a>) that includes prescription drug coverage.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Private Insurance Companies:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> plans are offered by private insurance companies that have been approved by Medicare. These plans operate alongside <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Original Medicare&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare refers to the traditional fee-for-service health insurance program offered by the federal government in the United States. It includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/original-medicare\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Original Medicare<\/a> (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> and <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a>) or <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part C&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part C, also known as Medicare Advantage, is an alternative way for beneficiaries to receive their Medicare benefits. Unlike Original Medicare (Part A and Part B), which is provided by the government, Medicare Advantage plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital services (Part A) and medical services (Part B) into a single plan, often with additional benefits. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-c\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Medicare Advantage<\/a> plans, providing coverage for prescription medications.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Coverage Tiers:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> plans typically organize prescription medications into different tiers. Each tier represents a different cost level, and medications in higher tiers usually have higher out-of-pocket costs. Generic drugs often have lower costs than brand-name drugs.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Deductibles, Copayments, and <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Coinsurance&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Coinsurance is a cost-sharing arrangement between an individual and their health insurance provider.&nbsp; Both parties share the costs of covered healthcare services after the individual has met their deductible. It is usually expressed as a percentage. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/coinsurance\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Coinsurance<\/a>:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> plans often have a yearly <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Deductible&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; &amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;An insurance deductible is the amount of money that you have to pay for certain types of claims before your insurance company will cover the rest.&nbsp;&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;Different types of insurance have different ways of applying them. Some are per claim, meaning you have to pay them each time you file a claim. Some are per year, meaning you only have to pay them once in a calendar year. Some deductibles are fixed amounts, while some are percentages of the total claim amount.&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;The size affects the cost of your insurance premium. Generally, the higher your deductible, the lower your premium, and vice versa. This is because you are taking on more or less risk by choosing a higher or lower deductible. You should choose a deductible that you can afford to pay in case of a claim, but also that suits your budget and needs.&amp;lt;\/span&amp;gt; &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/deductible\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">deductible<\/a>, which is the amount beneficiaries must pay out of pocket for prescriptions before their plan begins to pay. After meeting the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Deductible&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; &amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;An insurance deductible is the amount of money that you have to pay for certain types of claims before your insurance company will cover the rest.&nbsp;&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;Different types of insurance have different ways of applying them. Some are per claim, meaning you have to pay them each time you file a claim. Some are per year, meaning you only have to pay them once in a calendar year. Some deductibles are fixed amounts, while some are percentages of the total claim amount.&amp;lt;\/span&amp;gt;&amp;lt;span style=&amp;quot;color: #000000;&amp;quot;&amp;gt;The size affects the cost of your insurance premium. Generally, the higher your deductible, the lower your premium, and vice versa. This is because you are taking on more or less risk by choosing a higher or lower deductible. You should choose a deductible that you can afford to pay in case of a claim, but also that suits your budget and needs.&amp;lt;\/span&amp;gt; &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/deductible\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">deductible<\/a>, beneficiaries typically pay a <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Copayment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A copayment, often referred to as a copay, is a fixed amount of money that an insured person pays for covered healthcare services, usually at the time of receiving the service. This payment is a predetermined, out-of-pocket expense that helps share the costs of the healthcare service between the insurance provider and the insured individual. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/copayment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">copayment<\/a> or <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Coinsurance&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Coinsurance is a cost-sharing arrangement between an individual and their health insurance provider.&nbsp; Both parties share the costs of covered healthcare services after the individual has met their deductible. It is usually expressed as a percentage. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/coinsurance\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">coinsurance<\/a> for each prescription.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Coverage Gap (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Donut hole&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; The &amp;quot;donut hole&amp;quot; refers to a coverage gap in Medicare Part D prescription drug plans. This gap occurs after the initial coverage period and before entering the Catastrophic Coverage Phase. During the donut hole, beneficiaries may experience changes in their prescription drug coverage and cost-sharing. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/donut-hole\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Donut Hole<\/a>):<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">In the past, <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> included a coverage gap, commonly known as the &ldquo;<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Donut hole&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; The &amp;quot;donut hole&amp;quot; refers to a coverage gap in Medicare Part D prescription drug plans. This gap occurs after the initial coverage period and before entering the Catastrophic Coverage Phase. During the donut hole, beneficiaries may experience changes in their prescription drug coverage and cost-sharing. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/donut-hole\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">donut hole<\/a>,&rdquo; where beneficiaries had to pay a higher percentage of the drug costs. However, the Affordable Care Act has been gradually closing the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Donut hole&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; The &amp;quot;donut hole&amp;quot; refers to a coverage gap in Medicare Part D prescription drug plans. This gap occurs after the initial coverage period and before entering the Catastrophic Coverage Phase. During the donut hole, beneficiaries may experience changes in their prescription drug coverage and cost-sharing. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/donut-hole\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">donut hole<\/a>.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">The Coverage Gap (<a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Donut hole&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; The &amp;quot;donut hole&amp;quot; refers to a coverage gap in Medicare Part D prescription drug plans. This gap occurs after the initial coverage period and before entering the Catastrophic Coverage Phase. During the donut hole, beneficiaries may experience changes in their prescription drug coverage and cost-sharing. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/donut-hole\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Donut Hole<\/a>) Stage requires the beneficiary to pay 25% of the cost of the prescription drugs for both brand name and generic drugs.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">During this stage, certain CMS-contracted drug manufacturers will offer a discount on certain applicable &ldquo;brand&rdquo; drugs.<\/span><\/li>\r\n<li><span style=\"font-size: 12pt;\">This will continue until the total costs for drugs reach $8000 (in 2024). This amount reflects what you pay and the value of the manufacturer&rsquo;s discount on brand-name drugs.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Catastrophic Coverage:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Once a beneficiary&rsquo;s out-of-pocket spending reaches a certain limit, they enter the <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Catastrophic coverage phase&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; The Catastrophic Coverage Phase is a stage in the coverage of Medicare Part D prescription drug plans. It represents the final stage of the Part D benefit structure and is reached after a beneficiary has gone through the initial coverage period and the coverage gap (also known as the &amp;quot;donut hole&amp;quot;). &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/catastrophic-coverage-phase\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">catastrophic coverage phase<\/a>. During this phase, the Medicare beneficiary will no longer have a <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Copayment&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; A copayment, often referred to as a copay, is a fixed amount of money that an insured person pays for covered healthcare services, usually at the time of receiving the service. This payment is a predetermined, out-of-pocket expense that helps share the costs of the healthcare service between the insurance provider and the insured individual. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/copayment\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">copayment<\/a> or <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Coinsurance&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Coinsurance is a cost-sharing arrangement between an individual and their health insurance provider.&nbsp; Both parties share the costs of covered healthcare services after the individual has met their deductible. It is usually expressed as a percentage. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/coinsurance\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">coinsurance<\/a> for the rest of the calendar year.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Enrollment:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Beneficiaries can enroll in a <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> plan during their Initial Enrollment Period when they first become eligible for Medicare. Additionally, they can enroll or make changes to their <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> coverage during the Annual Enrollment Period (October 15 to December 7) each year.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Penalties for Late Enrollment:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Individuals who do not enroll in a <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> plan when first eligible but choose to do so later may face a late enrollment penalty unless they have creditable prescription drug coverage through another source.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<p><span style=\"font-size: 12pt;\">Medicare beneficiaries need to review available <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part D&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Medicare Part D is the prescription drug coverage portion of the United States government&amp;#039;s Medicare program. It provides coverage for outpatient prescription drugs, helping beneficiaries pay for the cost of their medications. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-d\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part D<\/a> plans annually to ensure they have coverage that meets their medication needs and to compare costs and coverage options.<\/span><\/p>\r\n<h2><span style=\"font-size: 12pt;\"><strong>Medicare Eligibility Criteria:<\/strong><\/span><\/h2>\r\n<p><span style=\"font-size: 12pt;\">The eligibility criteria are based on age and specific medical conditions. Here are the main factors determining eligibility:<\/span><\/p>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\"><strong>Age:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Individuals become eligible for Medicare when they turn 65 years old. This is the age at which most people qualify for benefits.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Work History:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Individuals may also qualify for premium-free <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> based on their work history or their spouse&rsquo;s work history. If they or their spouse paid Medicare taxes while working, they may be eligible for premium-free <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a>.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Disability:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Individuals under the age of 65 may be eligible if they have received <a href=\"https:\/\/www.usa.gov\/social-security-disability\">Social Security Disability Insurance (SSDI)<\/a> benefits or certain <a href=\"https:\/\/www.rrb.gov\/Benefits\/Disability\">Railroad Retirement Board disability benefits<\/a> for at least 24 months.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>End-Stage Renal Disease (ESRD):<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">Individuals of any age with <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/end-stage-renal-disease\/symptoms-causes\/syc-20354532\">End-Stage Renal Disease (ESRD)<\/a> or <a href=\"https:\/\/www.mda.org\/disease\/amyotrophic-lateral-sclerosis\">Amyotrophic Lateral Sclerosis<\/a> (ALS) are eligible. There is no waiting period for individuals with ALS.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><span style=\"font-size: 12pt;\"><strong>Automatic Enrollment:<\/strong><\/span>\r\n<ul>\r\n<li><span style=\"font-size: 12pt;\">If individuals are already receiving Social Security or Railroad Retirement Board benefits at the age of 65, they are typically automatically enrolled in <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> and <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a>.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<p><span style=\"font-size: 12pt;\">It&rsquo;s important to note that while <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part A&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part A is one of the four parts of the United States government&amp;#039;s Medicare program, which provides health insurance coverage for eligible individuals. Part A specifically covers hospital insurance and certain skilled nursing facility services. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-a\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part A<\/a> (hospital insurance) is generally premium-free for most eligible individuals, <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> (medical insurance) usually involves a monthly <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Premium&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; An insurance premium is the amount of money you pay for an insurance policy. It is the price of getting coverage from an insurance company. You can pay the premium monthly, quarterly, semiannually, or annually, depending on the policy. &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/premium\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">premium<\/a>. Some individuals may choose to delay enrollment in <a class=\"glossaryLink\" aria-describedby=\"tt\" data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Part B&lt;\/div&gt;&lt;div class=glossaryItemBody&gt; Original Medicare Part B is one of the four parts of the United States government&amp;#039;s Medicare program, providing health insurance coverage for eligible individuals. Part B is often referred to as medical insurance, and it covers a wide range of outpatient services, preventive care, and medically necessary services &lt;\/div&gt;\" href=\"https:\/\/medisure.agency\/articles\/glossary\/part-b\/\" target=\"_blank\" data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]' tabindex=\"0\" role=\"link\">Part B<\/a> if they have other qualifying health coverage, such as through an employer. Understanding the eligibility criteria and enrollment timelines is crucial to ensure individuals receive timely access to benefits. Additionally, individuals can apply online through the official Social Security website or by visiting a local Social Security office.<\/span><\/p>\r\n<h2><span style=\"font-size: 12pt;\"><strong>Conclusion:<\/strong><\/span><\/h2>\r\n<p><span style=\"font-size: 12pt;\">In summary, Medicare is a key foundation of the <a href=\"https:\/\/en.wikipedia.org\/wiki\/Healthcare_in_the_United_States\">U.S. healthcare system.<\/a> It provides comprehensive coverage and protections against <a href=\"https:\/\/medisure.agency\/articles\/2022\/07\/21\/no-more-surprise-medical-billing\/\">surprise medical billing<\/a>. For senior citizens and those with disabilities, staying informed about its components and eligibility is crucial.&nbsp; This knowledge helps individuals make informed decisions, fostering a healthier and more secure future for all.<\/span><\/p>\r\n<p><span style=\"color: #000000; font-size: 18pt;\"><!-- \/wp:post-content --><!-- \/wp:pagelayer\/pl_col --><!-- \/wp:pagelayer\/pl_row --><\/span><\/p>\r\n<p>&nbsp;<\/p>","protected":false},"excerpt":{"rendered":"<p>Introduction to Medicare: Medicare is a federally funded health insurance program.&nbsp; It caters primarily to those aged 65 and older.&nbsp; It also covers younger individuals with disabilities or specific medical conditions. Medicare is funded through a combination of payroll taxes, premiums paid by beneficiaries, and general revenues. The funding sources are described as follows: Payroll [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":533,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","pagelayer_contact_templates":[],"_pagelayer_content":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[4],"tags":[],"class_list":["post-531","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-insurance"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.6 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>What is Medicare: 2024 - The Medisure Agency Blog<\/title>\n<meta name=\"description\" content=\"Medicare provides essential health coverage for seniors and the disabled. 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