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Parts of Medicare

When looking at Medicare, the first thing you will notice is that Medicare is divided into four parts.  These parts are what can create some confusion to those new to Medicare.  “What are the different parts, what do I need to know, and most importantly, what parts do I need?,” may be questions you are asking.

To make things simple, we can break each part down into simple terms to help differentiate between each option:

Part A: Hospital Insurance

Part A is your Hospital Insurance which is designed to help cover common hospital expenses such as hospital visits, blood transfusions, hospice, home health care, and skilled nursing facility care. You can think of Part A as coverage for “room and board” when you are in the hospital.  Part A generally has no cost to you as long as you have worked at least 10 years in the United States.

Medical Insurance

Part B is the part of Medicare that covers outpatient services including things like doctor visits, lab work, diagnostics, imaging, surgeries, ambulance services, preventative care, chemo and radiation, and other primary services by your doctor.  You will need to pay for Part B coverage.

When you combine Part A and Part B, you get what is also called “Original Medicare”.

Part C: Medicare Advantage (Supplemental Insurance)

Medicare Advantage Plan also known as Part C, is generally considered your supplemental insurance because it can cover some of the things left out in Part A and Part B. It’s usually done in private companies or agents, and you need to actively enroll to get the Advantage Plan (this means you need to be enrolled in both Part A and Part B to qualify for a Part C plan. For more detailed information about the various types of Part C, set an appointment with one of our Medicare experts.

Prescription Drug Insurance

Part D is a program created to help lower the out-of-pocket costs for retail prescription medications.  Part D plans are through private insurance carriers.

What Parts of Medicare Do I Need?

With Medicare, deciding what parts you need and what coverage in which to enroll will depend on many factors and your individual situation.  If Medicare is your only coverage, it is wise to get both parts of Original Medicare (Part A and Part B) yet you may also want to consider a Part C plan and possibly Part D as well.  

An important thing to keep in mind, is that you may incur substantial penalties if you enroll late, particularly if you don’t have other coverage, such as through your employer.  To avoid penalties, you will want to enroll during your Initial Enrollment Period.

If you still have questions and would like to speak with one of our Medicare agents, schedule a call today.