The cost of Medicare can vary depending on several factors including your income, the specific Medicare plan you choose, and the state you live in. In general, Medicare Part A, which covers hospital stays, is available for most people who have paid Medicare taxes for at least 10 years. Medicare Part B, which covers doctor visits and other outpatient services, has a standard monthly premium that is set by the government. In 2024, the standard monthly premium for Part B is $174.70. However, some people may pay more based on their income. Medicare Part C, also known as Medicare Advantage, and Part D, which covers prescription drugs, are provided by private insurance companies and the cost can vary depending on the specific plan you choose. It's important to note that there may also be deductibles, copayments, and coinsurance associated with different Medicare plans. Schedule a consultation to get a free, no-obligation quote.

Traditional Medicare refers to Parts A and B of the Medicare system. Part A covers hospital stays, home health care, hospice and in-patient services, such as rehabilitation facilities. Part B covers doctors, out-patient services, preventative treatments and medical equipment, among others. Medicare covers most services at 80%, and some services like hospitalizations and skilled nursing facilities are subsidized even more. People covered by Traditional Medicare may receive treatment from any provider who accepts Medicare; there are no network limitations. Traditional Medicare doesn’t offer coverage for most prescription drugs. Standalone Part D prescription drug plans are available, and many Medicare Advantage plans offer prescription coverage. Read more about Traditional Medicare here.

Medicare Advantage plans are offered under Part C of Medicare. Sometimes called Medicare replacement plans or Medicare secondary plans, these plans are offered by private companies, not Medicare. Advantage plans are contracted with Medicare to deliver Medicare benefits, and some even offer extra benefits that Medicare doesn’t cover such as dental, vision, hearing and wellness coverage, among others. Medicare Advantage plans usually have a network of healthcare providers that you must use to receive care, and may require referrals to see specialists. Many Advantage plans are available with $0 monthly premiums, making them attractive to those who only want to pay for services as they are needed instead of paying a monthly premium.

Medicare Supplements, sometimes called ‘Medigap plans’ are add-on policies that help fill ‘gaps’ in Traditional Medicare coverage. They are sold by private companies and help cover co-payments and deductibles. These policies typically have a higher premium than Medicare Advantage plans, but pay for most if not all co-payments. If you value peace of mind and want to be sure that medical needs are covered, a Medicare Supplement may be a good option for you.

In terms of Medicare, HMO and PPO describe the type of provider network offered by a Medicare Advantage plan. HMO stands for Health Maintenance Organization, a type of insurance policy which typically requires members of the plan to use only certain providers that are contracted with the HMO. Seeing providers that are outside of the HMO's network are usually not be covered by the plan. PPO stands for Preferred Provider Organization. These plan types have a preferred network of providers, and using preferred providers will have the lowest co-payments. However PPOs also allow members to receive care outside of the preferred network, but with higher out-of-pocket costs.

Traditional Medicare coverage does not cover dental services such as cleanings, exams, x-rays fillings or extractions. However, some Medicare Advantage plans offer dental coverage as an extra benefit, in addition to standard Medicare coverage. For many people, standalone dental insurance purchased outside the Medicare system is a good option. There are several insurance companies that offer dental coverage at affordable rates. Graybird Insurance brokers can make recommendations for dental coverage that's based on your individual needs.

Insurance premiums are the monthly costs for people to be covered by an insurance plan, similar to a monthly subscription. For example, a plan with a $39 premium requires its members to pay $39 per month to keep their policy active.

Deductibles are the amounts members pay for covered services before an insurance plan starts to pay. For example, with a $200 prescription deductible, members would pay the first $200 of the cost of their prescriptions. After the deductible is met, members will pay smaller co-payments or co-insurance for their prescriptions instead of the full price.

Co-payments and co-insurance are the amounts of a medical bill that are the member's responsibility to pay. The insurance company covers the remaining amount due. More specifically, a co-payment is a set rate you pay for prescriptions, doctor visits, and other types of care. The rate is determined by the insurance company. Co-insurance is the percentage of costs you pay if a flat rate is not set by the insurance company. For example, a Medicare Advantage plan could require a $30 co-payment to see a specialist, or charge members 20% co-insurance of the cost of medical supplies.

Licensed Medicare brokers are paid commissions by insurance companies for each client they enroll in a plan. Our clients never pay us for Medicare insurance consultations or sales.