Exploring Medicare
November 10, 2021 | Tags: Medicare

Did you know there are four different parts to Medicare? They are identified by letters – A, B, C and D. Parts A and B are offered by the government and together are known as Original Medicare. Parts C and D are offered through private insurance companies. Find out about the coverage each Medicare part provides:

Part A: Hospital Insurance

Medicare Part A covers care you receive in a hospital or other healthcare facility, like a nursing home. If you’ve worked at least 10 years while paying Medicare taxes, you most likely won’t have to pay for Part A, though there are other costs, such as deductibles, that you will need to pay. Part A coverage includes:

  • Inpatient hospital care
  • Skilled nursing facilities following a hospital stay
  • Hospice care
  • Home healthcare

Learn more about Medicare Part A.

Medicare Options 1

Part B: Medical Insurance

Medicare Part B covers medically necessary services that don’t require an overnight hospital stay, such as visits with your primary care provider or outpatient services. There is a monthly premium you must pay for Medicare Part B that is set by the Centers for Medicare & Medicaid Services (CMS). In 2020, the standard premium amount was $144.60 per month. Medicare Part B coverage includes:

  • Doctor and other healthcare provider visits
  • Outpatient hospital care
  • Preventive services, like colonoscopies and mammograms, to help detect problems before you notice symptoms
  • Injectable drugs and vaccines, like those you might receive to treat osteoporosis
  • Many other medical services and supplies not covered by Medicare Part A

Some people choose to decline Part B because they already have coverage through an employer. If you don’t have employer-sponsored insurance and decline Part B, you can enroll at a later date. However, your monthly premium might be higher than the standard premium if you wait until after your initial enrollment period to enroll.

Learn more about Medicare Part B.

Part C: Medicare Advantage

Medicare Part C, or Medicare Advantage, combines both Medicare Part A and Medicare Part B. These plans are offered through health insurance carriers, like Medical Mutual. There is usually a monthly cost, though there are some plans that have a $0 premium. You must continue to pay your Medicare Part B premium to enroll in a Medicare Advantage plan. Medicare Advantage plans:

  • Tend to come with lower out-of-pocket costs, such as deductibles and copays, compared to Original Medicare
  • Usually offer additional benefits, such as vision and dental
  • Often include prescription drug coverage (Part D)
  • Typically provide extras such as allowances for over-the-counter supplies, hearing aids, eyewear, and access to programs like SilverSneakers®

Learn more about Medicare Part C.

Medicare Option 2

Part D: Prescription Drug Coverage

Medicare Part D is an optional prescription drug benefits plan. Part D plans are available to anyone enrolled in Medicare Part A or B and are often included with a Medicare Part C (Medicare Advantage) plan. You can join a Part D plan in two ways: purchase a standalone Part D plan and add it to Original Medicare or enroll in a Medicare Advantage plan that includes Part D coverage. Part D coverage:

  • Helps lower your prescription drug costs and protect against future drug cost increases
  • Provides greater access to medically necessary drugs

Learn more about Medicare Part D.

So, the next time someone mentions Medicare, ask which parts they mean — A, B, C, D, or all of the above. In our next video and blog post, we’ll talk more about the Medicare options you have.

Want to Learn More?

To learn more about Medicare, visit Medicare.gov, view our Medicare section, or like our Facebook page to see the latest updates in this series. You can also download our Understanding Medicare Guide for more details.

Need More Information?

Talk to your doctor. If you are a Medical Mutual member and don't already have a primary care physician, use our online tool to find an in-network doctor near you.

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Sources: The Cleveland Clinic, The Center for Disease Control and Prevention

The material provided is for your information only. It does not take the place of your doctor’s advice, diagnosis or treatment. You should make decisions about your care with your doctor. What is covered by your health insurance will be based on your specific benefit plan.