Parts of Medicare

Medicare is a public health care program designed for older adults and people with disabilities. 

Once you’ve been accepted to the Medicare program, you will have access to every part of Medicare. Each part administers a separate portion of your health care benefits, and you must opt into the benefits you want. 

These are the parts of Medicare. 

Original Medicare

Original Medicare is the typical plan offered by Medicare. It consists of both Parts A and B. Part A is your hospital insurance, while Part B is your medical insurance. 

This is what you can expect from your Part A and Part B coverage.

Part A:

Your Part A benefits provide you with coverage for services rendered within a hospital setting. This includes skilled nursing facility care, nursing home care, and hospice care. In many cases, home health care services can also be covered under Part A. 

Part A benefits can be acquired premium-free in some cases, but in order to acquire the plan at no cost, you must have contributed adequately to Medicare taxes. If you are not eligible for premium-free Medicare, you will be required to pay a monthly premium to maintain your benefits. 

The most common use for Part A benefits is to pay for inpatient hospital care, which includes lab tests, surgery, and more. While Medicare covers a large portion of the costs, there may be some out-of-pocket costs associated with receiving Part A covered health care services. Check with your health care provider to determine what out-of-pocket costs will be required for the services you’ve requested. 

Part B:

Part B covers medically necessary services and preventive health care services. To get Part B, you must pay a monthly premium. Under this part of Medicare, you gain access to coverage for ambulance services, clinical research, durable medical equipment, limited outpatient prescription drugs, and more. 

Any supplies or services required to diagnose or treat your medical conditions is covered by this portion of your coverage. It also covers services designed to prevent or detect illnesses at an early stage. 

To find out if a service you need is covered by Part B, ask your doctor. Their administrative team should be able to help you find out what is and isn’t covered. 

Medicare Advantage (Part C)

If you’re enrolled in Original Medicare but would like to have some extra coverage, you can enroll in a Medicare Advantage (Part C) plan. These plans are offered by private insurance companies, which allows them to offer a greater range of essential benefits. Part C plans provide all of the same benefits as Original Medicare, but they are also able to include supplemental benefits in their plans. 

Some of these supplemental benefits include:

  • Dental coverage
  • Vision coverage
  • Hearing coverage
  • Meal delivery
  • Transportation
  • Prescription drug coverage

These plans come in a variety of different forms, so shop wisely to find one that fits your needs. To get help finding an Advantage plan that works for you, it’s best to get in touch with an insurance professional. 

Part D

Medicare Part D governs the prescription drug coverage portion of your Medicare benefits. Similar to Part C, Part D plans are offered by private insurance companies that have been approved by Medicare. If you want to purchase a plan, you can find them being offered by one of many insurance providers in your area. 

Part D plans provide affordable coverage for a set list of drugs called the formulary. Medicare requires all Part D plans to cover several drugs in each of the following categories:

  • HIV/AIDS treatments
  • Antidepressants
  • Anticonvulsive treatments for seizure disorders
  • Immunosuppressant drugs
  • Antipsychotic medications
  • Anticancer drugs (unless covered by Part B)

Discover Medicare

Now that you know what benefits are included under the different parts of Medicare, you can choose your coverage. Contact Avina Financial Group to get started with a free consultation. We’ll help you find coverage that fits your retirement needs. 

  • How could my income affect my monthly Medicare premiums?

  • Do I need to sign up for Medicare Part A and B if I'm still working?

  • How can private insurance help me with the costs of Medicare?

  • How do I avoid the coverage gap with Medicare Part D prescription drug plans?

Ready to begin your Medicare journey?