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.
Content contained on this page is for informational purposes only and does not constitute medical advice. Consult your insurance provider for more information regarding your specific health plan. References provided are for informational purposes only and do not constitute endorsement of any websites or other sources. Should you have any insurance-related questions, you should contact your insurance organization or a licensed agent.
Sources:
https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/parts-of-medicare
https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679