Medicare Insurance Parts Breakdown – Part A, B, C & D Explained

Medicare is the federal health insurance program for people 65 and older.  Certain people younger than age 65 can qualify for Medicare, including those who receive Social Security Disability Income and those who have permanent kidney failure.  Because Medicare is a health insurance, you share the costs of your care.

Parts A, B, C and D

Traditional medicare is also called Original Medicare or “Fee for Service” medicare.  This federal program starts with Part A and Part B.  For most people, Original Medicare Part A and Part B is a starting poing for assembling more complete coverage.

• Hospital Insurance (Part A): This helps pay for inpatient care in a hospital or a skilled nursing facility (following a hospital stay), some home health care and hospice care.  Part A is premium-free for most people, but beneficiary share costs through deductibles and co-insurance.
• Medical Insurance (Part B): This helps pay for doctor’s services and many outpatient medical services and supplies.  Part B is technically optional because most beneficiaries must pay a monthly premium; it comes with an annual deductible plus a 20 percent co-pay.  If you want a Medigap supplement or a Medicare Advantage plan to help pay the co-pays, you must have both Parts A and B.
• Medicare Advantage (Part C):  Instead of getting your Medicare benefits through the original government program, you can get them through a private insurance compamny’s Medicare Advantage (MA) plan.  These plans combine all your Medicare covered Part A and Part B benefits in a single package and can include prescription drug coverage (Part D).  You must have Parts A and B before you canenrol;l in a Medicare Advantage plan.  Medicare Advantage plan members pay a premium for Part B, plus usually a premium for the Medical Advantage Plan, and co-pays or co-insurance for services.  Medicare Advantage plans are not the same as Medicare supplements (Medigaps), which work only with Original Medicare.
• Prescription drug coverage (Part D):  This Medicare coverage is offered through private companies- either as a part of a Medicare Advantage plan or as a stand-alone prescription drug plan for those with Original Medicare.  Having either Part A or Part B, or both, makes you eligible for Part D.  Part D plan members pay a premium and pharmacy co-pays; some plans also include a deductible.  Some people can get Part D through their employer group plan or the Department of Veteran Affairs.

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