12/05/2025
Medicare Alert!! NO!! You can NOT have Medicare parts A, B, C and D. Nor can you have Medicare parts A, B, C! The insurance company is just trying to generate Insurance Leads when the commercial says “If you just have Medicare Parts A & B, you need C.” NO!, NO!, and No! Let’s break it down. The Medicare Parts (A, B, D, and C, are INSURANCE and all Insurance has a Premium. This is NOT free Government care. One of the most important pages in the Medicare and You handbook is on page 10. Please look closely at the picture. There are 2 MAIN ways to get Medicare. Original Medicare also known as Traditional Medicare is composed of Part A-Hospital-only coverage. If you worked AND paid into Social Security for at least 10 years, Part A does not have a monthly premium. Part B which covers medically Necessary outpatient services, which include doctor's services, ambulance services, durable medical equipment (as prescribed by a prescription from a doctor), many preventive services, etc. It does NOT cover routine dental or vision, hearing care or Long term care that is NOT medically Necessary. Part B has a monthly PREMIUM of at least $202.90 for 2026 unless in TN, your monthly income from all sources is less than about $1,781 for an individual and less than about $2,380 for a married couple. Then you MUST add Part D which is Medication coverage which is provided by individual insurance companies and usually has a monthly premium from a low of $3.60 per month to a high of $107 per month, PLUS the copays for the medication. If you don’t add Part D as in Drugs, even if you don’t take any medicines, you will pay a lifetime penalty once you do add it. We are still on the left side of the page for Original Medicare. If your income for 2026 is too high, (see figures above) for the state to help, you will have a hospital deductible of $1,736 per benefit period if you need to go to the hospital. If you need to go to a Skilled Nursing Facility, [SNFs]after day 20, you will have a copay of $217 per day. Part B will have a deductible of $283 before Medicare will start paying for Part B covered services. After the deductible is met, you will pay 20% of covered Part B services. IF you get a Medicare Supplement plan which is only available under Original Medicare, (see picture) the plan will usually pay the hospital deductible, the per day cost at SNF, etc. It will NOT pay the Part B deductible or any drug deductibles or copays. The monthly premium for a supplement plan can run from $100 p/m up to over $400 per month. The premiums are age based. Every year you age, the premiums go up. Now look at the right side of the page in the picture. There you see Medicare Advantage plans also known as Part C! There is a line drawn down the middle of the page for a reason. You can NOT have both sides. Part C includes Hospital, doctor's services, ambulance services, durable medical equipment (as prescribed by a prescription from a doctor), many preventive services, etc. AND many plans offer Dental, Vision, Hearing coverage as well as Over the Counter cards. As they offer the same services as offered by Part B under Original Medicare, you will pay the Part B premium of at lease $202.90 for 2026 unless you meet the income limits as described above. You might ask, “What is the best plan?” The best plan is the plan that works for YOU!! Rarely do any two individuals have the exact same plan, even people living in the same house. S.H.I.P. [State Health Insurance Assistance Program] counselors, using the medications you take, the doctors you see and your income can help determine what is the best individualized plan for you. Check us out on Page 108 of the Medicare and You handbook. [see picture below] And just FYI, while these are the 2 MAIN ways to get your Medicare Coverage, there are many other ways. i.e.: Federal Employee Health Benefits Plan, VA, TriCare for Life and any and all Retiree Plans by your Employer. If you qualify for any of these plans, you probably already know what they are. Call TN-S.H.I.P. for help, 877-801-0044.
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