The Parts of Medicare: Original Medicare and Private Medicare Policies Explained

There are a few different parts of Medicare, including a few private Medicare policy options.

 As you approach Medicare eligibility and consider enrolling in Medicare – or if you’re already enrolled in Medicare – it’s important to know more about your Medicare coverage options.

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What are the 4 parts of Medicare?

There are four distinct parts of Medicare:

  • Medicare Part A hospital insurance
  • Medicare Part B medical insurance
  • Medicare Part C, also known as Medicare Advantage
  • Medicare Part D prescription drug coverage

Original Medicare (Medicare Part A and Part B)

Original Medicare consists of two parts: Part A and Part B

  • Part A provides coverage for inpatient hospital stays and other types of inpatient care.

    Most people receive Part A without paying a monthly premium, due to having paid Medicare taxes for 40 quarters (10 years).

  • Part B covers doctor’s appointments, certain other types of outpatient care and durable medical equipment (DME).

    Medicare Part B is optional, and it comes with a standard premium of $135.50 per month in 2019. Higher income earners may pay more than this amount for their 2019 Part B premiums.

Medicare Advantage (Medicare Part C)

Medicare Advantage plans (Medicare Part C) are an alternative to Original Medicare. These plans are sold by private insurance companies and include all of the same coverage as Part A and Part B.

Some Part C plans also offer benefits that Original Medicare doesn’t cover, such as routine dental, vision, and hearing care. Most Medicare Advantage plans include prescription drug coverage.

The selection, cost and benefits included in a Medicare Advantage policy may vary from one location of the country to another.

A licensed insurance agent can help you find a Medicare Advantage policy available where you live. You can call to speak to an agent at TTY Users: 711 24/7.

Medicare Part D

Medicare Part D provides coverage exclusively for prescription drugs, which are not typically covered by Original Medicare.

A standalone Medicare Part D policy, also sold by a private insurance company, can be used alongside your Medicare Part A and/or Part B coverage.

Many Medicare Advantage plans include Part D prescription drug coverage.

The cost, selection and drugs covered by a Medicare Part D plan may differ from one location to another.

What is covered by a Medicare Supplement policy?

Medicare Supplement Insurance (also called Medigap) helps cover some of the out-of-pocket expenses that are left behind by Medicare Part A and Part B.

A Medicare Supplement Insurance policy can cover costs such as certain Medicare deductibles, coinsurance and copayments. There are 10 types of standardized Medigap plans available in most states.

Medigap plans are sold by private insurance companies, and plan selection and costs may vary.

You may not have a Medigap policy and Medicare Advantage policy at the same time — they do not work together.

How do you choose a Medicare policy?

Finding the right Medicare coverage for your needs may depend on your unique circumstances, financial resources and the availability of private Medicare policies in your area.

  • Almost every Medicare beneficiary has Medicare Part A, and most beneficiaries qualify for premium-free Part A.

  • Although Medicare Part B is optional, you are required to enroll in Part B if you want to enroll in a Medicare Advantage policy or a Medigap plan.

  • Around one out of every three Medicare beneficiaries is enrolled in a Medicare Advantage plan in 2019.

    Some beneficiaries might choose a Medicare Advantage plan because of extra benefits the plan offers. Other beneficiaries might choose Part C because of the out-of-pocket spending limit the plan gives them.

    To get help comparing 2019 Medicare Advantage plans in your area and the benefits that they offer, call to speak with a licensed insurance agent at TTY Users: 711 24/7.

  • If you want Medicare coverage for your prescription drugs, you may want to consider enrolling in a Part D plan (or a Medicare Advantage plan that includes prescription drug coverage).

    The availability of plans and the drugs that they cover may vary. A licensed insurance agent can help you compare your Medicare prescription drug coverage options.

  • A Medigap plan may be a good fit for you if you want to have more predictable health care spending.

    Medigap plans can help pay for certain Medicare out-of-pocket costs, which can help give you more predictability.

Get help choosing a Medicare Advantage policy

There’s a lot to know about Medicare policies beyond Part A and Part B. There are only certain times of the year in which you may enroll, eligibility standards, costs, conditions and more.

A licensed insurance agent can help answer your questions about Medicare Advantage plan coverage, eligibility and enrollment. Call today to learn more about finding a Medicare Advantage policy that works for you.

 

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.