There are 4 main parts of Medicare: Parts A, B, C, and D.
|Medicare Part||What does it cover?||How much is the premium||Who provides coverage?|
|Part A||Basic hospital services||$0 (for most people)||Federal government|
|Part B||Basic non-emergency medical services||Most people pay $135.50 each month in 2019||Federal government|
(Medicare Advantage plans)
|Same as Parts A & B, plus may include additional benefits like dental and prescription drug coverage||Depends on plan||Private insurers|
(Prescription Drug Plans)
|Prescription drugs||Depends on plan||Private insurers|
Medicare Part A is the first part of Original Medicare. You must have Part A to enroll in Medicare Parts B, C, or D.
Part A is considered hospital insurance and covers services such as inpatient hospital care, hospice care, home health care, and blood transfusions.
Most people do not pay the Part A premium. It is free if you or your spouse paid Medicare taxes while working, or if you are eligible to receive retirement benefits from Social Security or the Railroad Retirement Board.
If you do have to pay for it, Part A may cost up to $437 per month in 2019.
Medicare Part A hospital insurance does come with out-of-pocket costs.
In 2019, more than 61 million people were enrolled in Medicare Part A and/or Part B.1
Learn more about Medicare Part A.
Medicare Part B is the second half of Original Medicare. It is optional coverage. When you enroll in Part A, you can reject or accept Part B coverage.
Part B is considered medical insurance and covers health care services such as doctor visits, preventative services, durable medical equipment, and yearly wellness exams.
Medicare Part B comes with several costs, including premiums, deductibles, co-insurance, and co-payments.
Learn more about Medicare Part B.
Medicare Part C, also called Medicare Advantage, is a form of private health insurance that provides the same coverage as Original Medicare and may include additional benefits such as coverage for prescription drugs, dental, vision, and wellness programs.
You must be enrolled in Original Medicare before you can enroll in a Medicare Advantage plan. You cannot have a Medicare Advantage plan and a Medicare Supplement insurance policy at the same time.
There are 5 major types of Medicare Advantage plans. The type of plan you choose may affect your prescription drug coverage options, referral requirements, and network restrictions.
You must enroll in a Part C plan during certain enrollment periods, such as when you are first eligible for Medicare, or during the yearly Open Enrollment Period.
In 2019, more than 22 million people (34 percent of all Medicare beneficiaries) were enrolled in Medicare Advantage plans.2
Learn more about Medicare Part C.
Medicare Part D plans provide prescription drug coverage.
Part D prescription drug plans are offered by private insurers, not the federal government. Each plan has its own formulary (list of covered drugs) that impacts which prescription drugs are covered and how much you will pay for them.
You must enroll in a Part D plan during certain enrollment periods, such as when you are first eligible for Medicare, or during the yearly Fall Open Enrollment Period (known officially as the Medicare Annual Enrollment Period).
In 2019, more than 20 million people had prescription drug coverage through a stand-alone Part D plan.3
Learn more about Medicare Part D plans.
Medicare Supplement Insurance, or Medigap, is a type of private Medicare insurance that provides coverage for the out-of-pocket costs that Medicare Part A and Part B don't pay for.
Medigap plans help cover costs like Medicare deductibles, copayments, coinsurance, emergency care received outside of the U.S. and more.
A Medigap plan is designed to reduce out-of-pocket spending for beneficiaries of Original Medicare.
There are 10 standardized Medigap plans available in most states, and the coverage included in each type of plan is standardized no matter where it is sold.
Medigap plan costs and availability can vary from one location to another.
Now that we've outlined the four parts of Medicare (as well as Medigap), what are some of the possible combinations of Medicare coverage?
As a Medicare beneficiary, you may be enrolled a combination of coverage that could include:
There are different parts of Medicare for different needs. Structuring the best combination of coverage for your needs can depend on your situation.
Medicare Part B is optional. However, most Medicare beneficiaries typically choose to enroll in Part B.
Part C plans can be useful for beneficiaries who want to have their Part A and Part B benefits in a single plan. Many Part C beneficiaries may also prefer their plan because of possible coverage for things like routine dental care, prescription drug benefits, hearing aide coverage and more.
Part D plans may be useful for beneficiaries who are looking for prescription drug coverage and want to keep receiving their Original Medicare Part A and Part B coverage from the federal government.
Medicare Supplement plans are designed for beneficiaries looking to reduce their out-of-pocket Medicare spending and create more cost certainty around their care.
Now that you have the basics down, it’s time to start thinking about which type of Medicare coverage may be the best option for you.
To learn more about Medicare Part C plans and to find plans in your area, call a licensed insurance agent today or compare plans online.
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Or call 1-800-557-6059 (TTY: 711) 24/7 to speak with a licensed insurance agent.