Simplifying the 4 parts of Medicare:
What are the 4 parts of Medicare?
Medicare can seem complicated at a first. If we break it down into 4 parts, it becomes clear what coverage is provided and what your options are.
Part A: Hospital
Part A is hospital Insurance. This happens automatically and there’s no premium as long as you’ve worked a minimum of 10 years or 40 quarters and paid your Medicare taxes. Part A helps cover in-patient care in hospitals, skilled nursing facilities, hospice care, and home health care (inpatient care in a skilled nursing facility that’s not custodial or long-term care).
Part B: Medical
Part B is medical insurance. The current premium for most people is $144.60 per month, subject to your annual income 2 years prior. If you’re a high earner, you may pay a higher premium each month. Medicare Part B covers 80% of Medicare approved medical services once you’ve met the $198 annual deductible. Medical services can include doctor visits, hospital outpatient care, home health care, and preventative services like physical exams and flu shots.
Part C: Medicare Advantage and Medicare Advantage Prescription Drug Plans
Medicare Part C or Medicare Advantage Plans are Medicare approved managed healthcare plans offered by private insurance companies. In order to qualify, you need to have already set up Part A and B, live in the service area of the plan, and you cannot have end stage renal disease, commonly known as kidney failure. These types of plans combine the benefits and services covered under Medicare Part A and Part B, and often Part D, too. In other words, these plans bundle hospital, medical, and sometimes even prescription drugs. Additionally, some may include additional benefits like vision, dental, gym, over-the-counter benefits, and more.
Part D: Prescription drugs
Medicare Part D is a federally created program to help lower the cost of prescription drugs. This type of coverage is offered by private insurance companies and can be included in your Medicare Advantage Plan or as a stand-alone plan. Regardless, Medicare prescription drug coverage is always through Part D. When shopping for a Part D plan, always keep their prescription drug formulary, or list of covered drugs, in mind. All companies use their own covered drug lists, so make sure your plan covers your prescriptions. Lastly, Medicare Part D Plans are optional, but be aware that you may be subject to a late enrollment penalty should you decide to enroll in a Part D Plan at a later date.
We’re on Your Side
For a deeper look at cost, eligibility, coverage, and more, visit our sections on Medicare Part A, Part B, Part C, and Part D.
Still have questions or need assistance applying for your Medicare benefits? You’re not alone. AHIC is here to walk you through the process of applying for Medicare or shopping for the plan that’s right for you. Our services are free for you and we’ll be here to help for the lifetime of your policy.