What Are the Different Parts of Medicare?
Medicare consists of four main parts. Part A covers hospital care, Part B covers medical services, Part C (Medicare Advantage) combines Medicare benefits through private insurance plans, and Part D helps cover prescription drug costs.
If you’re used to the traditional healthcare marketplace, moving to a Medicare plan can be stressful. And, you’re likely navigating this space at the same time that you’re experiencing other monumental transitions. It can be difficult to know where to start when you’re overwhelmed by so much new information simultaneously.
| Medicare Part | What it Covers | Offered By |
|---|---|---|
| Part A | Hospital and inpatient care | Medicare |
| Part B | Doctor visits and outpatient care | Medicare |
| Part C | Medicare Advantage plans | Private insurers |
| Part D | Prescription drugs | Private insurers |
Medicare Part A: Hospital Insurance
Medicare Part A helps cover inpatient healthcare services, including hospital stays, skilled nursing facility care, hospice care, and certain home health care services. For many people, Part A is available with no monthly premium if they or their spouse have enough Medicare-covered work history. Eligibility typically begins when you turn 65, although some individuals may qualify earlier because of a disability.
Medicare Part A is often considered the foundation of Original Medicare because it helps cover the costs associated with being admitted to a hospital or receiving other inpatient services. Coverage is organized into benefit periods, which begin when you’re admitted to a hospital and end after you’ve been out of inpatient care for 60 consecutive days.
Medicare Part B: Medical Insurance
Medicare Part B helps pay for medically necessary services and supplies not covered under Part A. This includes doctor visits, outpatient services, physical and speech therapy, durable medical equipment, ambulance services, preventive care, and other medical treatments.
Unlike Part A, Part B typically requires a monthly premium and is considered voluntary coverage. Delaying enrollment when you’re first eligible may result in late enrollment penalties, depending on your situation. Medicare Part B generally works alongside Part A to form what is known as Original Medicare.
Medicare Part C: Medicare Advantage
Medicare Part C, also called Medicare Advantage, is offered through private insurance companies approved by Medicare. These plans provide an alternative way to receive your Medicare benefits and must offer coverage that is at least equivalent to Original Medicare Parts A and B.
Many Medicare Advantage plans also include prescription drug coverage and may offer additional benefits such as preventive dental care, routine vision services, hearing benefits, fitness programs, and over-the-counter allowances. Coverage, provider networks, and costs vary by plan.
You generally must be enrolled in both Medicare Part A and Part B before enrolling in a Medicare Advantage plan.
Medicare Part D: Prescription Drug Coverage
Medicare Part D helps cover the cost of prescription medications. Coverage is provided through private insurance companies and may be purchased as a standalone prescription drug plan or included within certain Medicare Advantage plans.
Each Part D plan has its own formulary, preferred pharmacies, deductibles, copayments, and coinsurance requirements. Because plans and covered medications vary, it’s important to review your options annually to ensure your medications remain covered at the most affordable cost.
Delaying enrollment in Part D when first eligible could result in a late enrollment penalty.
If you or your employees are nearing retirement, turning 65, or just looking for general information about Medicare, turn to M3 Elevate for insight and guidance. M3 Elevate’s Medicare team is at the ready to assist you with your questions about Medicare.
