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.
Part AMedicare Part A is known as hospital insurance. Part A is one of two parts (along with Part B) that make up Original Medicare.1 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 BMedicare 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 C5Medicare 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:
- Health and wellness programs
- Prescription drugs
Part DMedicare 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
- 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 NeedsMedicare 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.
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.