A Simple Primer on Medicare Parts A, B, C, and D

Before enrolling in Medicare, you may want a basic understanding of what it is and what the various parts of Medicare cover. Knowing these basics will help make sure you get the most out of your plan.

Medicare is a federal insurance program that pays for many health care expenses. Medicare enrollees are typically people age 65 and older. Certain younger people with disabilities and adults with certain approved medical conditions (like End-Stage Renal Disease or ESRD) or qualifying permanent disabilities may also be eligible for Medicare.

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are two main ways—Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Some people need additional coverage, like Medicare prescription drug coverage (Part D) or Medicare Supplement Insurance (Medigap). On the official Medicare website, you can go through steps to help you decide what coverage you want.

Medicare Part A covers inpatient hospital care, limited time in a skilled nursing care facility, limited home health care services, and hospice care. For most eligible people it’s free.

Medicare Part B covers certain non-hospital medical expenses like doctor office visits, blood tests, X-rays, diabetic screenings and supplies, and outpatient hospital care. You pay a monthly premium and that fee can be higher for people with high incomes.

Medicare Part C, or Medicare Advantage, is medical insurance that often includes every type of Medicare coverage in one health plan. It’s offered by private insurance companies as an alternative to Original Medicare. Enrolling in a Medicare Advantage plan is optional, but to obtain this private insurance, you must also have Original Medicare, Part A, and Part B. You also may have to continue to pay your Part B premium if you have a Medicare Advantage plan. While Medicare Advantage plans are required to provide all Medicare Part A and Medicare Part B benefits (except hospice care), plans can also include different additional benefits. The plans vary among the private insurance companies.

Medicare Part D is optional prescription drug coverage. It’s available as a stand-alone prescription drug plan through private insurance companies. The monthly fee varies among insurers. You will share in the costs of your prescription drugs according to the specific plan you enroll in. Your Medicare Part D costs might include a deductible, a flat copayment amount, or a percentage of the full drug cost (called “coinsurance”).

To learn more about Medicare visit https://www.cms.gov/Medicare/Medicare.html