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Understanding Medicare


Medicare is made up of four parts—A, B, C, and D—each covering different aspects of your healthcare. If you’re new to Medicare, this guide will help you understand what each part covers so you can make confident decisions about your coverage.

Medicare Part A – Hospital Insurance


What it covers:

Inpatient hospital stays

Skilled nursing facility care

Hospice care

Some home health services


Cost:

Most people don’t pay a monthly premium for Part A if they’ve worked and paid Medicare taxes for at least 10 years. There is a deductible and coinsurance for hospital stays.


Think of Part A as your coverage for care when you’re admitted to a facility.

Medicare Part B – Medical Insurance


What it covers:

Doctor visits and outpatient care

Preventive services (like screenings and vaccinations)

Lab tests and X-rays

Mental health services

Durable medical equipment (like walkers or wheelchairs)


Cost:

You pay a monthly premium (most people pay a standard amount set by Medicare each year).

There’s also a deductible and 20% coinsurance for most services after that deductible is met.


Part B covers the care you receive outside of a hospital.

Medicare Part C – Medicare Advantage Plans


What it is:

Medicare Advantage (Part C) is a plan offered by private insurance companies that combines Part A and Part B into one plan.

Most Medicare Advantage plans also include prescription drug coverage and extra benefits.


What it may include:

Dental, vision, and hearing coverage

Prescription drugs (Part D)

Fitness programs or wellness benefits

Lower out-of-pocket costs for some services


Cost:

You still pay your Part B premium, and some Advantage plans may charge an additional premium (some even offer $0 premium plans).


Part C offers an all-in-one alternative to Original Medicare with extra perks.

Medicare Part D – Prescription Drug Coverage


What it covers:

Helps pay for prescription medications

Covers brand-name and generic drugs

Each plan has its own formulary (list of covered drugs), which may vary


How to get it:

Enroll in a standalone Part D plan if you have Original Medicare

Or choose a Medicare Advantage Plan that includes drug coverage


Cost:

Monthly premium varies by plan

Copayments and deductibles may apply

Some people may qualify for Extra Help with drug costs based on income


Part D helps protect you from high prescription drug costs.

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Frequently Asked Questions

Do I need both Medicare Part A and Part B?

Yes—if you want full coverage for both hospital (Part A) and medical services (Part B). Most people get both when they turn 65 to avoid late penalties and gaps in coverage.

When can I enroll in Medicare?

Your Initial Enrollment Period is a 7-month window: 3 months before, the month of, and 3 months after your 65th birthday. You can also enroll later, but you may face penalties or limited options.

Does Medicare cover prescription drugs automatically?

Not with Original Medicare (Parts A and B). You’ll need to enroll in Part D for drug coverage, or choose a Medicare Advantage Plan that includes it.

How much does Medicare cost each month?

Part A is usually free for most people. Part B has a monthly premium (the standard amount can change yearly), and you may pay additional premiums for Part D, Supplement, or Advantage Plans depending on what you choose

Will Medicare cover all of my healthcare costs?

No—Medicare does not cover 100% of healthcare costs. You’ll still be responsible for deductibles, copays, and coinsurance. That’s why many people choose a Supplement Plan or a Medicare Advantage Plan to help with those costs.

Is dental, vision, or hearing covered by Medicare?

Original Medicare doesn’t cover routine dental, vision, or hearing services. Many Medicare Advantage Plans include these benefits.