Medicare Basics

The basic fundamentals of Medicare.

Medicare Part A

Medicare Part A coverage is hospital insurance.

It’s part one (of two) of what’s often referred to as Original Medicare. It is administered by the federal government. Medicare Part B (medical insurance) is the other part.

Medicare Part A helps pay for care you receive when you are admitted as an inpatient in facilities such as hospitals or skilled nursing facilities.

Part A

Medicare Part A covers the hospital charges and most of the services you receive when you’re in the hospital. However, it doesn’t cover the fees charged by doctors who participate in your care while you’re in the hospital. Medicare Part B helps pay those costs.

What Does
Medicare Part A Cost?

Most people get Part A automatically when they turn age 65. They do not have to pay a monthly payment, called a premium, for Part A because they or a spouse paid Medicare taxes while they were working.

Medicare Part B

Medicare Part B is medical insurance. It’s the other part of what’s often called Original Medicare, which is administered by the federal government. Medicare Part A (hospital insurance) is the other part. Original Medicare is Medicare Part A and Part B.

Medicare Part B helps pay for care you receive in a hospitals and clinics as an outpatient. Part B also covers most doctor services you receive as a hospital inpatient. Most other hospital services are covered by Medicare Part A.

What Does
Medicare Part B Cover?

Medicare Part B covers doctor visits and most routine and emergency medical services. It also covers some preventive care, like flu shots.

What Does
Medicare Part B Cost?

Medicare beneficiaries pay a monthly Part B premium. The premium is based on income and can change yearly.

Medicare Part C

Medicare Part C is also called Medicare Advantage. It’s an alternative to Original Medicare (Which includes Parts A and B).

Medicare Advantage plans are offered by private insurance companies approved by Medicare. You must be enrolled in both Part A and Part B to join a Medicare Advantage plan. You will still be in the Medicare program, but you will receive your benefits through the plan instead of through Original Medicare.

What Does
Medicare Part C Cover?

Medicare Advantage (Medicare Part C) plans combine coverage for hospital care, doctor visits and other medical services all in one plan. The plans are required to provide all of the benefits offered by Medicare Parts A and B (except hospice care, which continues to be provided by Part A).

Many plans also provide prescription drug coverage and additional benefits like routine dental and eye care.

Medicare Part D

Medicare Part D is prescription drug coverage. It helps pay for the medications prescribed by your Doctor.
Original Medicare (Parts A and B) does not cover prescription drugs.

Many people who choose Original Medicare add a prescription drug (Part D) plan or choose a Medicare Advantage plan that includes Part D.

In general, you may enroll in a Part D plan if you are entitled to Medicare Part A or if you are enrolled in Medicare Part B. In addition, you must live in the service area of a Part D plan.

What Does
Medicare Part D Cover?

Medicare Part D Plans are required to cover certain common types of drugs, but each plan may choose which specific drugs it covers. The drugs you take may not be covered by every Part D plan. You need to review each plan’s drug list, or formulary, to see if your drugs are covered.