Parts of Medicare

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Part A: Medicare Part A is the Hospital Insurance portion of the federal health insurance program that helps cover the costs of inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. For most people, Medicare Parts A and B do not require a monthly premium for Part A if they have worked and paid into the system for the required number of years.

Part B: Medicare Part B is Medical Insurance that covers outpatient services, including doctors' services, preventive care, mental health services, lab tests, and durable medical equipment. It is the second part of Original Medicare and helps pay for services you receive outside of a hospital stay. Together, Medicare Parts A and B are known as "Original Medicare." 

*Key Note: Original Medicare does NOT include the following: Dental, Vision, Hearing, or prescription drugs. For those looking for additional coverage, Medicare Supplement plans and Medicare Advantage options are available to enhance your healthcare benefits.

Medicare Part C, commonly referred to as Medicare Advantage, is a health insurance plan designed for individuals eligible for Medicare Parts A and B. Key Features: 

Comprehensive Coverage: Medicare Advantage plans typically encompass all services covered by Medicare Parts A (hospital insurance) and B (medical insurance), along with additional benefits such as prescription drugs, vision, dental, and hearing care. 

Private Health Insurance Providers: These Medicare Advantage plans are offered by private health insurance companies that have received approval from Medicare. 

Choice of Plans: There are various Medicare Advantage plans available, each featuring different coverage options and costs. 

Lower Out-of-Pocket Costs: Some Medicare Advantage plans may present lower out-of-pocket expenses compared to traditional Medicare. 

Wellness and Preventive Care: Many Medicare Advantage plans prioritize wellness and preventive care, including screenings and health education programs.

Medicare Part D is a vital prescription drug coverage option for individuals with Medicare, including those enrolled in Medicare Advantage plans. It assists in covering the costs of both brand-name and generic prescription drugs. Key Features of Medicare Part D include: 

Coverage: It provides coverage for a wide range of prescription drugs, encompassing both brand-name and generic medications. 

Prescription Drug Plan (PDP): Beneficiaries must select a PDP from a list of private insurance companies that offer Part D, which operates alongside Medicare Parts A and B. 

Cost: Part D includes an annual deductible, monthly premiums, and copayments or coinsurance for covered drugs. 

Network: Different PDPs may have unique networks of pharmacies where prescription drugs are covered. 

Eligibility: Individuals with Medicare, whether through original Medicare or a Medicare Supplement plan, are eligible to enroll in Part D.

Medicare Supplement, commonly known as Medigap, is a type of private insurance policy designed to assist with out-of-pocket costs that remain after Original Medicare (Medicare Parts A and B) has paid its share. This includes expenses like deductibles, copayments, and coinsurance. Medigap plans are standardized and are identified by letters, such as Plan F, G, or Plan N, and can only be purchased if you are enrolled in Original Medicare. These Medicare Supplement plans provide predictable costs and grant you the freedom to visit any doctor who accepts Medicare patients, without the need for a referral. How it works: When you incur a healthcare expense, Medicare Parts A and B will first cover its portion. A Medigap policy then covers the remaining costs, such as copayments, coinsurance, and deductibles, based on the specific plan you select. It’s important to note that you must continue to pay your Part B premium along with a separate premium for the Medigap policy. Key features include: Standardized plans, where plans with the same letter provide identical basic benefits, regardless of the insurance provider; guaranteed issue rights, which ensure that during your one-time Medicare Supplement Open Enrollment Period (a six-month duration starting when you turn 65 and enroll in Part B), you can purchase any Medigap plan without being denied coverage or charged more due to pre-existing conditions; no network restrictions, allowing you to see any doctor who accepts Medicare; and no referrals necessary to consult with a specialist. However, it’s crucial to understand that Medigap does not cover Medicare Part D (PDP), meaning you will need to enroll in a separate