What Are the 4 Parts of Medicare? A Simple Breakdown
Whether your 65th birthday is on the horizon or decades away, understanding what the 4 parts of Medicare are is important, since this government-sponsored program plays a role in future health care decisions. Medicare is made up of four parts — A, B, C, and D — each covering different aspects of health care.
Here’s a simple breakdown of each part.
Medicare Part A: Hospital Insurance
Medicare Part A is one half of Original Medicare. It generally covers:
- Inpatient hospital care
- Skilled nursing facility costs
- Hospice care
- Lab tests
- Surgery
- Some home health care services
Most beneficiaries don’t pay a monthly premium for Part A, though annually adjusted deductibles still apply.
Medicare Part B: Medical Insurance
Medicare Part B is the second half of Original Medicare. It generally covers:
- Physicians’ fees
- Outpatient hospital care
- Certain home health services
- Durable medical equipment
- Other services not covered under Part A
Part B comes with a monthly premium and an annual deductible, both of which are adjusted each year and vary based on the recipient’s income level.
Medicare Part C: Medicare Advantage Plans
Medicare Part C, commonly known as Medicare Advantage, is often viewed as an all-in-one alternative to Original Medicare. These plans are offered by private companies approved by the federal government.
While Medicare Advantage plans come with standardized minimum coverage, the additional protection offered can vary significantly from one plan to another due to differences in:
- Provider networks
- Premiums
- Copays and coinsurance
- Out-of-pocket spending limits
Comparing plans from different providers is generally the best way to find Medicare Advantage coverage that fits your needs, including for those in Fort Myers and across Southwest Florida, where multiple Medicare Advantage plans are available.
Medicare Part D: Prescription Drug Plans
Medicare Part D provides prescription drug coverage. While some Medicare Advantage plans include drug coverage, Part D is also sold as a standalone plan for those enrolled in Medicare Part A and/or Part B.
Each Part D plan has its own formulary — a list of covered medications organized by pricing tier. Formularies and pricing can vary from one Part D plan to another.
Frequently Asked Questions
What are the 4 parts of Medicare?
The four parts of Medicare are Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage plans), and Part D (prescription drug plans).
What does Medicare Part A cover?
Medicare Part A covers inpatient hospital care, skilled nursing facility costs, hospice, lab tests, surgery, and some home health care services.
What does Medicare Part B cover?
Medicare Part B covers physicians’ fees, outpatient hospital care, certain home health services, and durable medical equipment.
What is Medicare Part C?
Medicare Part C, also called Medicare Advantage, is an alternative to Original Medicare offered by private companies approved by the federal government, often combining hospital, medical, and sometimes drug coverage in one plan.
What is Medicare Part D?
Medicare Part D is prescription drug coverage, available either as part of a Medicare Advantage plan or as a standalone plan for those with Part A and/or Part B.
Where can I find more information about Medicare plans in my area?
Medicare.gov is the official source for exploring Medicare plans, formularies, and coverage details available in your specific area.
