Medicare is divided into 4 parts, and most people new to Medicare find this very confusing. Why do there have to be so many Medicare parts?? And what’s the difference between the parts of Medicare and Medicare plans?
Fortunately, we can break this down to make it simpler for you to understand. Medicare itself has parts (not plans), so let’s start with those 4 parts of Medicare.
Medicare Part A
Part A of Medicare is your hospital insurance. This helps you cover common hospital expenses for things such as the cost of a semi-private room for stays, hospice, home health care and even skilled nursing facility stays. This part of Medicare also covers blood transfusions requiring more than 3 pints of blood.
We often tell our clients to think of Part A as your room and board in the hospital. This part of Medicare provides you a place to stay, with meals, while you receive medical services. However, there are many things that happen in a hospital that fall under another part of Medicare – Part B.
Medicare Part B
Part B of Medicare is for outpatient services that are deemed medically necessary. Medicare Part B includes coverage for services like doctor office visits, lab testing, diagnostic imaging, preventive care, surgeries, ambulance rides, chemotherapy and radiation, and even extensive dialysis care for people with renal failure. Many of these procedures may occur in a hospital. However, they fall under Part B because physicians provide them.
Sometimes people will ask us if they really need Part B. The answer is YES if Medicare will be your primary coverage or only coverage. Read our blog here to learn more: “Do I Need Medicare Part B?”
Medicare Part C
Part C of Medicare is somewhat confusing. Unlike the other parts of Medicare, which cover specific medical benefits, Medicare Part C is just another name for private Medicare insurance. The Balanced Budget Act of 1997 created Part C, which is now referred to as Medicare Advantage.
Medicare Advantage plans are private health plans that you can choose instead of Medicare. You would get your Part A, Part B, and sometimes also Part D all from one insurance carrier that usually has a network of physicians. Part C plans can often have lower premiums than Medigap. However, you’ll pay more copays as you go along so they are not necessarily cheaper over the long term. Before enrolling in one, read our post on Medicare Advantage vs Medicare Supplement.
Medicare Part D
Part D is a federally created program to help you lower the cost of your retail prescription drugs. Unlike Medicare Part A & B, you will not enroll in Part D through the Social Security office. Instead, you will select one of the Part D plans available in your county from private insurance carriers, and by signing up for that plan, you will have enrolled in Part D.
Medicare drug plans have a monthly premium that you will pay to the insurance carrier, and in return, they give you significantly lower copays on your medicines than you would pay if you had no Part D insurance.
There are rules for when you can enroll and disenroll from these drug plans, so be sure to visit the Medicare Part D section of our website for more details about how your drug coverage under Medicare will work.
Want Personalized Help with your Medicare Parts?
Our friendly agents can walk you through these 4 parts of Medicare until you understand them well. Call (855) 732-9055 for a free consultation. Our team is very experienced at explaining Medicare parts and how they work. You’ll soon be an expert at different parts of Medicare and what they cover.
To continue learning Medicare, go next to: Medicare Supplements