Quick Start Guide to Understanding Medicare

Medicare Part A is the part of Medicare that covers hospital-related services. It helps pay for:

• Inpatient hospital care
• Skilled nursing facility care (after a qualifying hospital stay)
• Home health care (limited)
• Hospice care

Most people don't pay a premium for Part A because they earned it through paying Medicare taxes while working. It's often called "hospital insurance."

Medicare Part B is the part of Medicare that covers outpatient and medical services. It helps pay for care you receive outside the hospital, including:

• Doctor visits
• Outpatient services
• Preventive care (annual wellness visit, screenings, vaccines)
• Lab work and X-rays
• Durable medical equipment (wheelchairs, walkers, etc.)
• Emergency room and urgent care services (when not admitted)
• Certain home health services

Part B has a monthly premium, an annual deductible, and typically 20% coinsurance for most services after the deductible is met.

Medicare Part C, also known as Medicare Advantage, is an alternative way to receive your Medicare benefits through a private insurance company instead of Original Medicare. Here's what it includes:

• Combines Part A and Part B into one plan
• Most plans also include Part D prescription drug coverage
• Often offer extra benefits not included in Original Medicare, such as dental, vision, hearing, fitness memberships, and over-the-counter allowances
• Plans use provider networks (HMO, PPO, etc.), which means costs and rules vary by plan
• You still pay your Part B premium and sometimes an additional plan premium

In short: Part C bundles your Medicare benefits and often adds more coverage, all administered by a private insurance carrier.

Medicare Part D is the part of Medicare that provides prescription drug coverage. Here's what it includes:

• Helps pay for prescription medications you fill at a pharmacy
• Covers both brand-name and generic drugs
• Each plan has its own drug list (formulary) and tiers
• You may pay a monthly premium, plus copays or coinsurance for your medications
• Offered only through private insurance companies, not the federal government

You can join a Part D plan if you have Medicare Part A, Part B, or both, and you can change plans during set enrollment periods each year.