Comparison of Medicare Part A & B

Medicare is a federal health-insurance program meant to help senior citizens. It is possible to qualify for Medicare if you are under 65 years of age, but only if you have certain disabilities or diseases. Medicare is administered by the Centers for Medicare and Medicaid Services. Enrollment is not automatic, and you can only join during a specific open enrollment period. Medicare has four parts, but A and B are considered original, or traditional, Medicare. Part A and Part B are not the same, however, and have many different features.

Eligibility

• Most people are eligible for Medicare by simply reaching the age of 65. You must also be a United States citizen or permanent resident for five continuous years. If you are under 65, you can qualify for Medicare if you have received Social Security of Railroad Retirement Board benefits for 24 months, have Lou Gehrig's disease or have end-stage renal disease. If you qualify for premium-free Medicare Part A, you are automatically enrolled in Part B. However, since Part B requires a deductible, you can refuse Part B coverage.

Premiums

• Medicare Part A is available without premiums if you meet certain conditions. If you or your spouse have worked for at least 10 years and paid Medicare taxes, you can get Part A premium-free. Premium-free Medicare is also available to people who already get retirement benefits from the Railroad Retirement Board or Social Security. If you do not qualify for premium-free Part A, you may be able to purchase it if you also qualify for Part B. As of 2010, if you have 30 to 39 quarters of Medicare-covered employment, your premiums would be $254 per month for Part A alone. If you have fewer than 30 quarters of employment, the premium is $461 per month. Part B is not premium-free. In 2010, the Part B premium is $110.50 per month, except for people who have their Part B premiums deducted from their Social Security benefits. In those cases, Part B is usually $96.40 per month.

Benefits

• Part A Medicare offers mostly hospital benefits. Part A has coverage for inpatient services in skilled nursing facilities, long-term care hospitals, inpatient rehabilitation centers and critical access hospitals. Part A also provides benefits for home health care and hospice care. Part B has preventive benefits, which cover a number of services such as health screenings as well as flu shots, physical exams and smoking cessation therapy.

Supplemental Plans

• There are three basic ways you can add benefits to your original Medicare plans. One way is to get Parts A and B bundled together with other benefits in a Medicare Advantage (MA) plan. MA is offered through private insurance companies, which set their own rules, costs and services. You must be enrolled in both Part A and Part B to get Medicare Advantage. You can also add prescription benefits only through a Part D plan. To enroll in Part D, you only need one and not both parts of traditional Medicare. Finally, you could supplement your benefits through a Medigap policy. Medigap has many benefits to cover original Medicare's co-pays, co-insurance, excess charges and deductibles. You must usually have both parts of Medicare in order to sign up for Medigap.