Medicare A, B, C, and D

Medicare has four parts: Part A (Hospital Insurance) covers inpatient hospital care, skilled nursing after a qualifying stay, hospice, and some home health—often with a $0 premium if you’ve paid Medicare taxes long enough. Part B (Medical Insurance) covers doctor visits, outpatient services and procedures, preventive care, labs, and durable medical equipment; it has a monthly premium and cost-sharing, and higher-income enrollees may owe IRMAA. Part C (Medicare Advantage) is a private, all-in-one alternative that bundles A and B (often Part D too) and can include extras like dental, vision, and hearing, but typically uses provider networks and sets an annual out-of-pocket maximum. Part D adds prescription drug coverage through stand-alone plans or within Advantage plans, with costs based on the plan, drug tiers, and pharmacy—and penalties can apply if you delay without creditable coverage.




Understanding Medicare Parts

Medicare is divided into Four Parts — each with a unique role in your health coverage. Understanding them helps you build the right combination of benefits.

🩸 Part A — Hospital Insurance

  • Covers inpatient hospital stays, skilled nursing, hospice, and limited home health.
  • Usually premium-free if you’ve worked 10+ years.
  • Deductible: $1,632 per benefit period
  • Co-Insurance: Days 1–60: $0 after deductible, Days 61–90: $408/day coinsurance

🩺 Part B — Medical Insurance

  • Covers doctor visits, preventive care, lab tests, outpatient procedures, and durable medical equipment.
  • Premium: $185 (2025 standard), income-based.
  • Late penalty: 10% per year you delay enrollment.
  • Annual Deductible: $257 (2025 standard).
  • Co-Insurance: 20% (80% paid by Medicare.
  • Maximum-Out-Of-Pocket: Unlimited

🧭 Part C — Medicare Advantage

  • Combines Parts A + B, often Part D, into one private plan.
  • Usually includes extras: dental, vision, hearing, gym memberships, telehealth.
  • Plan Types: HMO, PPO, PFFS.
  • Out-of-pocket limits cap your yearly costs.

💊 Part D — Prescription Drug Coverage

  • Helps cover prescription medications.
  • Works through private insurance companies.
  • Premium: Varies by plan, income-based.
  • Late penalty: 1% per month without creditable drug coverage.
  • Costs vary by formulary tier and pharmacy network.

🧩 Medigap (Supplemental Insurance)

  • Optional for Original Medicare (A & B).
  • Covers deductibles, coinsurance, and copays.
  • Works nationwide — no networks.
  • Standardized by letter (Plans A, G, N, etc.).
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