5 Parts of Medicare

The 5 Parts of Medicare

Each of the five parts of Medicare offers coverage for different services, but in the end you will only sign up for 3 or 4 of those parts. Don’t let the letters confuse you. This page is a quick guide to help you understand how each part works. We can help you choose the right plan and ensure that you receive health insurance that suits your specific needs at a price that fits your budget.

Original Medicare (Parts A & B):

Directly distributed by the federal government.

 

Part A (Hospital Insurance)

Part A covers many aspects of medically necessary care, including hospital, nursing facility, home health, and hospice services. There is no premium if

  • you or your spouse have worked and paid Social Security and Medicare taxes for at least 10 years
  • have received Social Security disability benefits for at least 24 months
  • you have End-Stage Renal Disease.
  • Part B  (Medical Insurance)

Part B (Medical Insurance)

Part B covers medically essential and preventive services, including doctor visits, preventive treatment, essential medical equipment, disease screenings, outpatient care, laboratory tests, x-rays, rehabilitation, and mental health care.

Part B requires all those enrolled to pay a monthly premium, and unlike Part A, does not offer 100% coverage; the patient pays at least 20% of the cost for most services.

When you enroll in Original Medicare, you will most often choose both A & B, but under some conditions, you may elect to sign up for just Part A without penalty. Read more about Parts A & B

 

Medicare Supplements or Medigap

Medicare Supplements, or “Medigap” plans, are provided by private insurance companies and can be used to supplement the “gaps” in Original Medicare’s coverage. These “gaps” include the deductible and co-pays a patient is required to pay when enrolled in Original Medicare. Read more about Medicare Supplements.

 

Medicare Part D (Medicare Prescription Drug Coverage)

Medicare Part D provides outpatient prescription drug coverage only through private insurance companies that have contracts with the government. Part D can help lower the cost of your prescription drugs, and is offered through both Medicare Prescription Drug Plans and Medicare Advantage Plans. Read more about prescription drug plans.

Medicare Part C (Medicare Advantage Plans)

Medicare Advantage Plans (called Part C) enable private health insurance companies to offer Original Medicare benefits to patients in the form of Medicare Advantage Plans, such as HMOs and PPOs. You remain enrolled in Parts A and B, and they assume the responsibility of that coverage and cover other health services not covered by Original. Some Medicare Advantage Plans include Part D (Prescription Drug Coverage), as well as other health services and programs not covered by Original Medicare, sometimes hearing, vision, dental. You may have to pay a monthly premium for your Part C coverage, in addition to your monthly Part B premium. Read more about Medicare Advantage Plans