Medicare has four parts each covering something different.

Part A: covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. People who have worked 40 quarters do not pay a premium. Those who have not worked 40 quarters, like many SSI recipients, will have to pay a significant premium.  When a premium is paid for Part A, it is called Uninsured Medicare. Qualified Medicare Beneficiary (QMB) is the only buy-in program that covers this premium.

Part B: covers certain doctors’ services, outpatient care, medical supplies, and preventive services. Everyone on Part B must pay a premium. Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLMB) and Qualified Individuals-Group 1 (QI-1) will cover the Part B premium.

Part C: offered by a private company that contracts with Medicare to provide all Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. Most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage. No DHS program helps with the premiums for Part C plans.

Part D: covers prescriptions. These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans. Medicare should automatically enroll someone in their Extra Help program if s/he is on an active buy-in benefit [Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLMB) and Qualified Individuals-Group 1 (QI-1)]. Extra Help will help with the Part D premium up to a specified limit.

For additional information, refer to the MIPPA (Medicare Improvements for Patients & Providers Act website.

The Oklahoma Insurance Department is the designated Senior Help Line (SHIP) for Oklahoma. Anyone wanting to learn about Medicare Part C and D plans available in Oklahoma or get help with their Medicare provider can call 1-800-763-2828 or go to their website at SHIP Division – Senior Health Insurance Counseling Program.