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Resources to Help You Understand the Medicare Insurance Marketplace

Types of Medicare Insurance?

There are four parts to Medicare: Part A, Part B, Part C, and Part D.

Hospital Coverage (Part A)

Part A of Medicare is hospital insurance. The program helps cover inpatient hospital stays, including those in critical access hospitals and nursing homes (not long-term care or custodial care). It also helps pay for hospice care and some home health care.

Since most people already paid payroll taxes while working, they don’t have to pay a monthly premium for Part A coverage. If you don’t have enough work history, you can buy Part A when you’re first eligible for Medicare.

Medical Coverage (Part B)

Medicare Part B is the portion of Medicare that covers outpatient medical care, including doctor visits, preventive services, and some home health care. Part B also covers some durable medical equipment, such as wheelchairs and walkers.

Most people eligible for Medicare Part A (hospital insurance) are also automatically enrolled in Part B. There is a monthly premium for Part B coverage; most people also have to pay a deductible and co-insurance for their care.

Part B coverage is optional, but if you decide not to enroll when you’re first eligible, you may have to pay a late-enrollment penalty if you later decide to sign up.

Medicare Benefits (Part C)

Part C of the Medicare program is also known as Medicare Advantage. This part of the program provides beneficiaries with an alternative to Original Medicare, Part A (hospital insurance) and Part B (medical insurance).

Under Part C, beneficiaries can receive their Medicare benefits through a private health plan, such as a Preferred Provider Organization (PPO) or a Health Maintenance Organization (HMO). These plans typically have lower out-of-pocket costs than Original Medicare and may also offer additional benefits, such as dental or prescription drug coverage.

As with all parts of the Medicare program, beneficiaries must still pay a monthly premium for Part C coverage. Please visit the Centers for Medicare and Medicaid Services website for more information on Part C.

Prescription Drug Coverage (Part D)

Part D of the Medicare program is run by private insurance companies contracted by the federal government. The standard Part D plan covers both generic and brand-name drugs.

Part D plans have an annual deductible, after which you pay coinsurance for your prescriptions until you reach the out-of-pocket limit. You may also be responsible for a late enrollment penalty if you do not enroll in a Part D plan when first eligible.

If you are already enrolled in a private health insurance plan that includes prescription drug coverage, you may not need to enroll in a Part D plan. However, it is always best to compare your options to ensure you get the best coverage for your needs.

You can get Medicare coverage through Original Medicare or a Medicare Advantage Plan. If you have Original Medicare, you can buy a stand-alone Part D plan to help pay for your prescription drugs. You can also get other supplemental insurance policies to help pay for things that Medicare doesn’t cover, like dental and vision care.