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The 4 Parts of Medicare


Confused about Medicare A, B, C, and D?

You're not alone! Navigating the different parts of Medicare can feel overwhelming, but it doesn't have to be. This simple guide breaks down each part in plain language, explaining what it covers and how it fits into your overall healthcare.

Medicare Part A

Hospital Coverage

  • Inpatient Hospital Care
  • Skilled Nursing Care
  • Hospice & Palliative Care
  • Some Home Health Care


If you paid into Medicare taxes while working, there is no charge for Part A

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

  • Doctor Visits
  • Medicare Equipment
  • Lab Tests
  • Preventive Services


You need to choose Part B when you turn 65. Part B covers 80% of all medical costs not covered by Part A.

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

Medicare Advantage

  • Includes Part A
  • Includes Part B
  • Most often includes Part D
  • Often includes Dental & Vision

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.

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Frequently Asked

Questions

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  • What are the four parts of Medicare?

    • Part A: Covers hospital stays, skilled nursing facilities, hospice care, and some home health care. It's often premium-free for those who paid Social Security taxes for at least 10 years.
    • Part B: Covers outpatient services like doctor visits, diagnostics, preventive care, and some medical supplies. It has a monthly premium and usually carries a deductible.
    • Part C: Also known as Medicare Advantage, this combines Parts A and B into a single plan offered by private companies. It may include additional benefits like dental or vision coverage, but you'll typically need to pay an additional premium.
    • Part D: Covers prescription drugs, but is separate from Parts A, B, and C. It has a separate enrollment period and requires choosing a specific plan with monthly premiums, deductibles, and co-pays.
  • Who is eligible for Medicare?

    • You're generally eligible for Medicare at age 65 if you're a U.S. citizen or permanent resident.
    • People with certain disabilities or End-Stage Renal Disease (ESRD) may also qualify at younger ages.
  • What is the 2024 monthly premium for Medicare Part B?

    The standard Part B premium for 2024 is $174.70, but it can be higher depending on your income.

  • Is there a deductible for Medicare Part B in 2024?

    Yes, the Part B deductible in 2024 is $240. You'll need to pay this amount before Medicare starts covering most outpatient services.

  • How do I avoid a Medicare Part D penalty?

    • Enroll in a Part D plan during your Initial Enrollment Period (7 months around your 65th birthday) or a Special Enrollment Period if you qualify.
    • Consider a low-cost Part D plan even if you don't need medication yet. This avoids penalties and provides coverage for future needs.
  • What is typically included in Medicare Part C?

    • Part C plans cover the same services as Parts A and B, but may offer additional benefits like dental, vision, or hearing coverage.
    • Costs and covered services vary by plan, so it's important to compare options carefully before enrolling.
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