Medicare’s ABCD Made Simple

Medicare is government-provided health insurance to qualifying people over the age of 65. Coverage is broken up into various parts. When trying to understand Medicare’s parts, think about building blocks where all parts make up one complete house. Each Medicare part covers a particular healthcare service. Together, parts A, B, C, and D offer consumers the ability to customize and cover healthcare costs. 

 

 

Part A – This covers hospital care or inpatient care, hospice care, skilled nursing facilities.

 

Part B – Doctor office visits, outpatient care, preventive services, and medical supplies. This part is voluntary as coverage involves a monthly premium and annual deductible.

 

Part C – These are private insurance plans called Medicare Advantage Plans. Part C plans cover everything in Parts A and B, while also offering additional benefits, depending on the provider. These all-in-one plans often come with a premium.

 

Part D — This covers prescription drugs through the Medicare Prescription Drug Program.

 

 

Customers have options to choose how to enroll and set up their Medicare coverage. 

 

Let’s look at the difference between Medicare and Medicare Advantage.

 

Structure

Original Medicare:

Part A and B; Part D is separate

Medicare Advantage or “Part C”:

This is a private plan that bundles A, B, and usually D

 

Networks

Original Medicare:

You can use any doctor or hospital in the U.S.

Patients use doctors who are in a plan’s network

 

Supplemental Plans

Medigap helps cover out-of-pocket expenses not covered by Original Medicare. Medicare Advantage serves as other types of supplemental plans which may have lower out-of-pocket costs and provide extra coverage for vision, hearing, or dental.

 

Once you understand each of the parts and how they work, you’ll be ready to make the best decisions about your healthcare and aging well.

 

 

Related articles: 

• Medicare Basics