What Are The Parts Of Medicare

Are You Impacted?

Medicare is a health insurance program for:

1. People age 65 or older
   
   
2. People under age 65 with certain disabilities
   
   
3. People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant.)

Question Summary

• What are the four parts of Medicare?
  
  
• Who is eligible for Medicare?
  
  
• What is the 2023 monthly premium for Medicare Part B?
  
  
• Is there a deductible for Medicare Part B in 2023?
  
  
• How do I avoid a Medicare Part D penality?
  
  
• What is typically included in Medicare Part C?

Medicare Part A - Hospital Coverage

 Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice, palliative care, and some home health care if it’s medically required. Part A does NOT cover lab tests, doctor visits, or surgery. Those elements are covered in Part B. You will need to enroll for Medicare Part A at Social Security unless you are already receiving Social Security or Railroad Retirement benefits. If you are receiving Social Security or Railroad Retirement benefits, you will be automatically enrolled into Part A.

Medicare Part B - Outpatient Medical Coverage

Medicare Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. It also covers cancer therapy and kidney dialysis. You will need to enroll for Medicare Part B at Social Security unless you are already receiving Social Security or Railroad Retirement benefits. If you are receiving Social Security or Railroad Retirement benefits, you will be automatically enrolled into Part B. Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. In 2023 the Part B premium is $169.90 per month and the Part B deductible is $226 for 2023.

Medicare Part C - Often referred to as Medicare Advantage

Medicare Part C is also referred to as Medicare Advantage. Simply put, Medicare Advantage / Part C is a package that contains:

• Part A – Inpatient hospital coverage
• Part B – Outpatient medical coverage
• Usually Part D – Prescription drug coverage
• May include dental and vision coverage

Think of Medicare Advantage / Medicare Part C as a package. Combine Medicare Parts A and B and sometimes include Part D and the result becomes Medicare Advantage, otherwise referred to as Medicare Part C. Confusing, yes? 

Medicare Part D - Prescription Drug Coverage

Medicare Part D is simply a Prescription Drug Plan you purchase independently. Most people will pay a monthly premium for this coverage. In January 1, 2006, Medicare prescription drug coverage became available to everyone with Medicare. This coverage is to help you lower prescription drug costs and help protect against higher costs in the future. Medicare Prescription Drug Coverage is insurance. Private companies provide the coverage. Beneficiaries choose the drug plan and pay a monthly premium. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.

 Original Medicare 

As if there aren’t already enough terms, Medicare Parts A and B are also referred to as Original Medicare. That is all Original Medicare means, so don’t let that distract you. Check out the graphic at the top of this page. 

 A Quick Recap 

 ✔  Part A is inpatient hospital coverage and is premium free for   most people if specific elements are met

 ✔  Part B is inpatient medical coverage

 ✔  Part C is Medicare Advantage coverage

 ✔  Part D is prescription drug coverage