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Part A - Hospitalization: What it covers

Part A

  • $1,600 Deductible Per Benefit Period

    • New benefit period is started if no re-admittance within a 60  day timeframe​

  • After deductible is met, Part A covers 100% of costs in most cases​

    • Days 61-90 cost $400 per day (per benefit period)​

    • Days 91 & beyond cost $800 per day (60 day lifetime reserve max)

Part B - Professional Services: What it covers

Part B

  • $226 Annual Deductible​

  • 80% Coverage After Deductible

    • No maximum cap or max out of pocket –  unlimited risk exposure

Part C - Medicare Advantage:

Medical form with stethoscope

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Medicare ELigibility

Income and Cost Adjustment

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  • Private insurance companies approved by Medicare provide this coverage. In most plans, you need to use plan doctors, hospitals, and other providers or you may pay more or all of the costs.

  • You may pay a monthly premium (in addition to your Part B premium), deductible, copayments, or coinsurance for covered services.

  • Costs, extra coverage, and rules vary by plan.

Part D - Prescription Drug Coverage:

  • Typically used in conjunction with original Medicare & a standard supplement

    • Can be paired with a PFFS Medicare Advantage Plan​

  • Many drug cards available with varying costs, formularies, co-pays, medication tiers, and pharmacy networks​

  • ​All drug cards must cover substantially all meds in the following six classes:

    • Anti-Psychotic, Anti-Convulsant, Anti-Depressants, Immuno-Suppressant, HIV/AIDS, Antineoplastic​

  • Unlike standard supplements, Medicare Part D plans can be changed each year during open enrollment​

    • Availability of plans varies greatly depending on zip code/county of residence​

  • Medicare.Gov provides an excellent Part D search tool​

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Learn More about Medicare Part D here

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