Medicare Part A, B and D

Seniors Living Healthy

Show Notes

• 00:00 Introduction
• 00:22 Medicare part A
• 06:39 Medicare part B
• 15:35 Medicare part D

Links Referenced:

• medicare.gov: https://medicare.gov
• Zach’s email: mailto:[e-mail]
• Nick’s email: mailto:[e-mail]
• Facebook: https://www.facebook.com/seniorbenefitinc
• Webpage: https://seniors-livinghealthy.com/

Transcript

Announcer: Welcome to our fireside chat with Seniors Living Healthy, the podcast that helps prepare and educate you as you enter and live out your golden years. With over 10 years of experience, Nick and Zach are experts in the senior market and are here to help you live a healthy, full life. And now fireside with your hosts, Nick Keene, and Zach Haire.

Nick: Hello, and welcome to season two of Seniors Living Healthy, episode one. I’m Nick. And I have Zach, our co-host with us.

Zach: Hey, folks.

Nick: And for episode one of season two, we want to cover parts A, B, and D of Medicare, and the changes for 2022. So Zach, let’s jump right in.

Zach: Sounds good. So, kind of start off there from the top, Part A, just like in the alphabet, starting out with the first letter there, you know, that is our hospitalization, sir. You know, Nick, what are some common things that Part A covers?

Nick: Yeah, so Part A kicks in when individuals are admitted to the hospital. It’s worth mentioning, Zach, that they’re admitted because we are seeing more commonly that people are being put in the hospital under observation. And that is actually covered under Part B. So, very simply, anytime someone is admitted to the hospital, not under observation, Part A kicks in.

Zach: Got you. So, let’s say, you know, I’m getting ready to turn 65 in a few months. I’m still working things like that, how do I get Part A? What do I have to do to qualify for it?

Nick: Great question, Zach. We do get this question quite frequently. So, the most common way to qualify for Medicare is those individuals that have worked 40 quarters or ten years and paid into Medicare via payroll taxes, right? Those individuals get Medicare the month of their 65th birthday.

Zach: Got you. So, no matter what, they’re going to get Part A. I know you said you paid into it while you’re working. Is there any additional costs added to that?

Nick: Right. So, great question there, Zach, and worth mentioning here as well. For those individuals that qualify traditionally for Medicare, they worked 40 quarters, ten years, and paid in, Part A is premium-free, think of it as prepaid. But also you have those individuals that may qualify based on their spouse’s, right? Their spouses may have worked 40 quarters or ten years, they also qualify for Medicare Part A the month of their 65th birthday.

Then the third situation, there is a cost. And those individuals that don’t have a spouse that qualifies for Medicare they can draw off of and don’t have the credits themselves, depending on how much they have worked and paid in, Part A can be purchased.

Zach: Yeah. So, you do still have the ability to get Part A, if you don’t ‘qualify’, you can always pay for that and pick it up.

Nick: Absolutely.

Zach: So, we know that in most cases, there’s no additional premium; you’ve paid into it as you were working. Are there any other, you know, common costs associated with using Part A, whether it be a deductible, whether it be you know, skilled facility care, things such as that?

Nick: Absolutely. So, yeah. So, basically with Part A, the way it works is it’s designed with what we call a Medicare period of care, right? So, when those individuals that have Part A are admitted to the hospital, they are immediately responsible for a $1,556 deductible in the year 2022 that covers their first 60 days in their period of care, right? So, for those individuals, they go in, they pay that $1556 deductible, they’re covered for the first 60 days, right?

But it’s worth mentioning that if they go beyond day 60 they do have additional cost, right? And that period of care doesn’t end until they go a continuous 60 days without accessing care under Part A. So, assuming their period of care extends, day 61 through 90, those individuals are going to be responsible for $389 a day that they’re in the hospital, and day 91 and beyond using those 60 lifetime reserve days, they’re going to be responsible for $778 a day. You know, and the other thing to touch on here, Zach, that you mentioned is skilled facility care, right? So, we’ve seen a major transition in our market over the last five to ten years.

You can recall when we were little, people had extended stays in the hospital, you know, people were in their one, two, four, six months. That doesn’t happen really anymore, right? What we’re seeing, the trend is individuals are being admitted to the hospital, they’re being stabilized, and they’re being shipped off to skilled facility care centers, right? And you know, whether that’s for a hip replacement or a knee replacement, they fell and they broke something, speech, occupational therapy, whatever it may be, these individuals are staying at the skilled facility care centers for extended periods of time, not in the hospital. So, to qualify for Medicare to cover skilled facility care, they have to be in the hospital for at least three days and be admitted to the skilled facility care center within 30 days of being discharged. If those criteria are met, Medicare will cover day 1 through 20, one hundred percent, and then day 21 through 100, the individual is responsible for $194.50 per day.

Zach: Got you there. So, you know, once someone is on Part A [everything 00:05:16], is there any limits where they can go, networks, anything like that?

Nick: Yeah, one of the beauties of Medicare, Zach, and you know, we tell clients this all the time is Medicare’s a nationwide program, right? California, North Carolina, Michigan, to Florida, and everywhere in between. They can access care, right? And that’s one of the great things about Medicare is almost all facilities, almost all doctor’s office accept Medicare. So, they have no restrictions, they can go just about anywhere they want.

Zach: Got you. So, kind of wrapping up Part A there is, anyone can get that as long as you’ve worked 40 quarters or your spouse has worked 40 quarters. You’re able to get that the month you turn 65, the first day of the month.

Nick: Absolutely.

Zach: And no matter whether you’re continuing working or what you’ve got Part A?

Nick: Yep.

Zach: And with Part A alone, there was a $1,556 deductible on that they’d be responsible for but then, you know, it does help you in the skilled facility care things such as that, along with your 60-day continuous window of care. And again, no network so you can go wherever you want to go if you’ve got that Part A; pretty much every hospital, I’d say, in America takes Medicare.

Nick: Absolutely, Zach. And just to wrap up on Part A, you know, one of the things that people need to remember is Part A is just hospital admittance insurance. Most of your typical services that are everyday needs are happe...