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Each one of the Medicare parts provides different types of coverage. They can cover medical services and supplies that you need to maintain a healthy lifestyle, prescription medications, or when you need help with hospitalization and skilled nursing care fees.

What Are the Four Parts of Medicare?

There are four parts to the Medicare program: Original Medicare Parts A and B, Medicare Advantage Part C, and Medicare Part D for prescription drugs. What each part covers can vary based on federal and state laws, as well as private insurance company policies. 

When you’re eligible for Medicare, you can apply for Part A of the Original Medicare program, which covers necessary hospital services. You can choose to opt into Part B, which covers medical expenses for services and treatment. If you choose to apply for Part B coverage, the cost is generally taken from your Social Security benefits. 

Part A

Medicare Part A is known as hospital insurance. Part A is one of two parts (along with Part B) that make up Original Medicare.It can cover necessary hospital services if you need to treat a disease or illness. In general, Part A covers:2
  • Inpatient care in a hospital
  • Skilled nursing facility care
  • Nursing home care that's not custodial or long term
  • Hospice care
  • Home health care

Part B

Medicare Part B is known as medical insurance. It covers medically necessary services needed to diagnose or treat your medical condition, illness, or disease. Part B also covers preventive services that can head off an illness or catch it early when treatment is most effective. In general, Part B covers:3
  • Clinical research
  • Ambulance services
  • Durable medical equipment (DME)
  • Mental health
  • Getting a second opinion before surgery4
  • Limited outpatient prescription drugs

Part C5

Medicare Part C is not a separate benefit. Also known as Medicare Advantage, it is offered by private insurance companies that are approved by Medicare. Instead of receiving your Part A and B coverage from Original Medicare, you’ll get it from your Part C plan.

Medicare Advantage Plans offer the same coverage as Original Medicare, excluding hospice care. Original Medicare covers this even though you’re enrolled in Part C. However, depending on your plan, Part C can offer more coverage than Original Medicare. This can include: 
  • Vision
  • Hearing
  • Dental
  • Health and wellness programs
  • Prescription drugs

Part D

Medicare Part D helps cover the cost of prescription drugs. You can add Part D coverage through a stand-alone Prescription Drug Plan (PDP) bought from a private insurance company or as part of your Medicare Advantage plan.6

Part D can help pay for your brand name or generic prescription drug medications.You may need to pay a monthly premium when you enroll in this plan and pay out of pocket for deductible (if applicable), copayment, and coinsurance costs.8

Part D coverage costs will vary based on:9
  • Your prescriptions and if they’re covered by your plan.
  • The “tier” of the drug.
  • Your drug benefit phase.
  • Your pharmacy.  
  • If you qualify for Extra Help (Low Income Subsidy) that helps pay your Part D costs.

How to Pick the Right Plan for Your Needs

Medicare is a multi-faceted United States program that is meant to work with your medical needs. Whether its Medicare Parts A and B, Medicare Advantage Part C, or Medicare Part D, HealthMarkets understands the complexities and can help you navigate them to find Medicare coverage.

Our innovative FitScore® can help you compare your options and find the plan that’s right for your needs, at no additional cost to you.

Get started reviewing plans today.

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References:
1. Medicare.gov. Retrieved from https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices Accessed on January 29, 2021. 

2. Medicare.gov. Retrieved from https://www.medicare.gov/what-medicare-covers/what-part-a-covers Accessed on January 29, 2021.
3. Medicare.gov. Retrieved from http://www.medicare.gov/what-medicare-covers/part-b/what-medicare-part-b-covers.html Accessed on January 29, 2021. 
4. Medicare.gov. September 2020. Retrieved from https://www.medicare.gov/Pubs/pdf/02173-Getting-a-Second-Opinion-Before-Surgery.pdf 
5. Medicare.gov. Retrieved from https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans/how-do-medicare-advantage-plans-work Accessed on January 29, 2021. 
6. Medicare.gov. Retrieved from https://www.medicare.gov/drug-coverage-part-d/how-to-get-prescription-drug-coverage Accessed on January 29, 2021. 
7. Medicare.gov. Retrieved from https://www.medicare.gov/drug-coverage-part-d/what-medicare-part-d-drug-plans-cover Accessed on January 29, 2021. 
8. Medicare.gov. Retrieved from https://www.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance Accessed on January 29, 2021.
9. Medicare.gov. Retrieved from https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage Accessed on January 29, 2021. 

HealthMarkets’ FitScore intends to identify plans that fit your needs. You should carefully review official plan materials.

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