If you’re getting ready to retire, you should start brushing up on the parts of Medicare. There are four Medicare parts in total, and it’s important to know what each one entails before you begin dotting the I’s and crossing the T’s on your paperwork.

We’re just going to cover the bare-bones basics in this article to give you a solid foundation and help simplify things in the future. Understanding this basic information first will help you put together a comprehensive Medicare plan at a cost that’s most affordable to you.

Four Parts of Medicare

Four parts to Medicare apply to every individual who enrolls in the program. Those (creatively named) parts include:

  1. Part A – Inpatient and Hospital Services
  2. Part B – Doctor and Outpatient Services
  3. Part C – Medicare Advantage
  4. Part D – Stand-Alone Prescription Drug Coverage

Part A typically covers hospital expenses. Part B helps with outpatient costs (like regular check-ups and non-hospital care). Part D helps beneficiaries pay for their prescription drugs.

Part C is a whole different animal compared to the other three parts. It includes the same benefits as the first two parts of Medicare and usually helps with prescription drug costs. Medicare Advantage plans can offer additional benefits Medicare doesn’t cover.

Medicare Part A

Part A has benefits in place to help beneficiaries as you pay for inpatient hospital care and similar services. In addition to hospital care, Part A helps pay for:

Beneficiaries who’ve worked at least 40 quarters consecutively during their employment years will not have to pay a monthly premium for Part A. But you’ll have a deductible to pay per benefit period if you require care and coinsurance costs, which will vary based on the length of your hospital stay.

Medicare Part B

Part B encompasses regular doctor visits, outpatient services, and durable medical equipment. It also covers the costs of outpatient procedures like simple surgeries and physical rehabilitation.

There is a standard monthly premium that most beneficiaries will pay, as well as an IRMAA for higher-income beneficiaries. However, most beneficiaries pay the standard premium. Part B also comes with an annual deductible.

After you meet your deductible, you’ll have a coinsurance payment which costs 20% of your Medicare-approved cost of treatment.

Medicare Part C

Part C, also known as Medicare Advantage, is a different health plan than the other three Medicare parts and must include the same benefits as Part A and B.

In addition, to covering the same benefits as Traditional Medicare, most include drug coverage. These plans also include additional benefits in most cases. Additional benefits included could include dental, vision, hearing, gym memberships, and more.

Part C Medicare plans will operate like the typical health insurance policies you had while working. These plans are managed by private health insurance companies like Humana or Aetna, not the government. Most areas with low premiums and many regions have zero-premium programs available.

To be eligible for a Medicare Advantage plan, you must have an active enrollment in both Part A & Part B. You still have to pay your monthly premium for Part B and your premium for Part C.

Medicare Part D

Private providers manage Part D, but those companies are endorsed and regulated by the government. You pay a monthly premium that varies based on where you live and your chosen provider. These plans follow the four-phase structure outlined by the Centers for Medicare and Medicaid Services.

Recipients who are on expensive prescriptions may fall into what is known as the Part D donut hole. But once you hit a specific annual out-of-pocket expense cap, emergency coverage will kick in and discount your medications to a more manageable level until the first of the following year.

FAQs

What parts are known as Traditional Medicare?

Tradition Medicare refers to Part A and Part B. These parts cover your inpatient hospital, doctor, and medical services.

What’s the difference between Medicare Parts C and Part D?

Part C is an all-in-one plan that combines the benefits of Parts A, B, and in most cases, D. In addition to the primary benefits, these plans offer additional coverages and benefits that Traditional Medicare doesn’t

Part D is stand-alone prescription coverage.

Is Medicare Advantage and Part C the same thing?

Yes! Medicare Advantage is another name for Part C. These are all-in-one plans that include Parts A, B, and D benefits in one program.

Is Medicare Part A and Part B free?

No, If you have worked at least 40 quarters, which is ten years, or are married to a spouse that has, you’ll qualify for premium-free Part A benefits. Part B has a standard premium that most people have to pay.

Help with Understanding Medicare and Your Options

Many people need additional assistance with understanding how Medicare works. There are a few paths and a ton of choices. We’re here to help guide you and ensure that you understand your plan options and can make the best decision for you.

Our agents are experts when it comes to all aspects of Medicare. They’re standing by to educate and help walk you through the process.

Give us a call today!! If now isn’t a good time, fill out our online request form, and one of our specialists will reach out to you!

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by Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.