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Turning 65 or getting close to Medicare eligibility can feel confusing. You may have heard about Medicare, but still wonder what it really covers and how it works. 

Many seniors in Saint Louis face the same questions. Knowing the basics of Medicare Parts A & B can help you make smarter decisions about your healthcare. 

This guide breaks it down in a clear, step-by-step format.

Things to Know About Medicare Parts A & B

• Medicare Parts A & B form the foundation of your coverage

Medicare consists of several parts, but Parts A & B cover most of the basics. Part A generally handles hospital-related costs. This includes inpatient care, skilled nursing stays, hospice care, and certain home health services. 

Part B covers medical services, such as doctor visits, outpatient care, preventive screenings, and medical equipment. Together, these two parts form a foundation that can help protect you from major healthcare costs. Knowing what each covers helps you plan for your medical needs.

• Part A is usually premium-free if you qualify

Most seniors won’t have to pay a monthly premium for Part A if they or their spouse have paid Medicare taxes for at least 10 years. That said, it doesn’t mean you won’t have any costs. 

There are deductibles and coinsurance for hospital stays, and these can add up. It’s important to factor these potential out-of-pocket expenses into your budget. Being aware of what’s covered and what isn’t can save you from surprises down the line.

• Part B requires a monthly premium and covers medical services

Unlike Part A, Part B usually comes with a monthly premium. It helps cover expenses such as doctor appointments, lab tests, preventive services, and durable medical equipment. You’ll also have copays or coinsurance for most services. 

The amount you pay can vary depending on your income. Understanding how Part B works will help you plan ahead and avoid unexpected costs.

• Timing your enrollment is very important

Enrolling at the right time can save you money and prevent penalties. Most people should sign up during their Initial Enrollment Period, which starts three months before their 65th birthday and lasts for seven months. 

If you miss this window and don’t have other coverage, you could face late enrollment penalties, which increase your monthly premiums. Planning ahead is always better than scrambling at the last minute.

• Coverage alone may not be enough

While Medicare Parts A & B cover many hospital and medical services, they don’t cover everything. For example, prescription drugs, dental care, vision, and hearing are usually not included. 

You might want to look into a Part D prescription drug plan or a supplemental plan, such as Medigap, to fill in the gaps. Understanding the limitations of Original Medicare helps you make decisions about what extra coverage you might need.

• Preventive services are included in Part B

Part B covers many preventive services at no extra cost. This includes screenings for cancer, diabetes, and heart disease, as well as flu shots and wellness visits. Taking advantage of these preventive services can help you stay healthier longer and catch problems early before they become serious.

For example, getting a yearly wellness visit allows your doctor to review your medications, check for early signs of chronic conditions, and make recommendations to improve your overall health. These preventive measures are covered under Part B, which means you don’t have to worry about extra bills. Using these services can help you maintain your independence and quality of life as you age.

• Understanding Medicare Parts A & B helps you compare other plans

Knowing the basics makes it easier to compare additional options like Medicare Advantage or supplemental plans. Once you understand what Original Medicare covers, you can decide if you want extra coverage for things like prescription drugs, dental, or vision.

If you live in Saint Louis, you have access to local resources that explain these choices clearly and help you find a plan that fits your needs. Using a trusted guide can help you avoid mistakes and save money. By understanding Medicare Parts A & B, you’ll feel more confident making decisions and can choose coverage that meets your personal health needs.

• Medicare Parts A & B are just the start of your coverage

It’s easy to get overwhelmed by all the choices. But if you focus on what Parts A & B cover first, you have a solid foundation. 

Once you understand that, you can look at supplemental plans or Medicare Advantage plans that add benefits like prescription coverage or dental. Being informed gives you the power to choose plans that work best for you instead of feeling forced into decisions.

What’s Next?

Medicare Parts A & B provide essential coverage for seniors, but they are just the starting point. Knowing what is included, what costs to expect, and when to enroll can make the process much less stressful. If you live in Saint Louis, you can get local guidance to help you compare your options and find coverage that fits your health needs. Show Me 65 is a trusted resource that offers clear, independent advice to help you make the best decisions about Medicare without confusion.