What should people know about Medicare and its parts?
Answered by 43 licensed agents
So, which people know about Medicare and its parts? Well, it's the alphabet soup of Medicare. Part A covers your hospitalization and stay in a skilled nursing facility. I like to relate it to your lumpy bed and your bad food. Part B is your doctors, labs, exams, tests, procedures, ambulance, emergency room, even medications when it comes to things like chemotherapy and IV infusions. Basically, any medicine that's not a medicine out of the pharmacy. But D is your drug plan. Something new with drug plans for this year is it may not have a $2,000 max in the pocket, which is great for those who have expensive medications. And then there's also what's called Part C of Medicare. Somehow A plus B plus D equals C. Thank you, government math. A C plan is a Medicare Advantage plan that combines your A, your B, and most of the time your D into an all-in-one plan. And then also, it's not one of the parts of Medicare, but you have Medicare gap or Medicare supplement plans that fill in the gaps of Medicare A and B. I hope that was helpful, and I look forward to welcoming you soon if we can help you out.
Answered by Bill Green on August 14, 2025
Broker Licensed in FL, AL, AZ & 19 other states
The question has come in: what should people know about Medicare? Medicare is broken up into two categories. Part A is for hospital services, and Part B is for medical services. This is what we're referred to as an 80/20 plan. Medicare covers up to 80% of the cost of your care, and you are responsible for 20% of your care for both A and B.
The problem with just regular Medicare is the cost you would have if you were admitted to the hospital. You can't see your doctor, and there are insurance deductibles. So, the best thing to do is to sit down with a licensed Medicare agent so they can review what your options are with Medicare itself.
This covers Part A for hospital services and Part B for medical services. Again, it's an 80/20 plan, and your responsibility is for 20% of whatever those medical bills are. So, it is highly recommended that you sit down with a licensed Medicare agent to review what your options are when it comes to selecting a plan. I hope that answers your question.
Answered by Gary Church on February 2, 2026
Broker Licensed in Ca, AZ, NV & TX
Medicare part B covers Doctors visits, preventive services, and Medical equipment
Medicare part C are the are the Medicare advantage plans. and Medicare part D are the drug plans.
Answered by George Ibanez on May 19, 2026
Broker Licensed in AR, AL, AZ & 40 other states
Answered by Ann Sanfelippo on January 5, 2026
Broker Licensed in FL, AL, AZ & 14 other states
Understanding these parts helps you see what’s covered, what’s not, and whether you need anything additional.
Medicare Part A – Hospital Coverage
This helps cover:
Hospital stays
Skilled nursing facilities
Home health (in certain situations)
Hospice care
Most people get Part A with no premium because they paid Medicare taxes while working.
Medicare Part B – Medical Coverage
This helps cover:
Doctor visits
Outpatient care
Lab work and imaging
Preventive screenings
Durable medical equipment
Part B has a monthly premium, which Medicare sets each year.
Medicare Part C – Medicare Advantage Plans
These are plans offered by private insurance companies.
They must cover everything Parts A and B cover, but many plans add:
Dental
Vision
Hearing
Over-the-counter benefits
Gym memberships
Transportation
Part D drug coverage
You still stay in Medicare — you just receive your benefits through the insurance company instead of the federal program.
Medicare Part D – Prescription Drug Coverage
Helps cover the cost of medications, both generic and brand-name.
Plans vary by pharmacy networks and medication lists, so reviewing your prescriptions each year is important.
Medicare Supplements (Medigap)
Not a “part,” but good to know.
These plans help pay the out-of-pocket costs that Original Medicare (A & B) doesn’t cover, such as:
Deductibles
Copays
Coinsurance
These do not include dental, vision, or hearing — they focus strictly on medical cost-sharing.
The biggest thing to remember:
Medicare isn’t one size fits all. Your doctors, prescriptions, and personal health needs all determine which setup fits you best. A good agent will walk you through the differences and help you choose a plan that works with your lifestyle.
Answered by Lauren Fodde on November 24, 2025
Broker Licensed in MO & FL
Part C was introduced in 1999 and it combines all the coverage of Parts A,B and D. Although sometimes incorrectly referred to as "Medicare Replacement", Part C requires participants to have (and keep) Parts A and B in place before getting Part C.
Answered by Paul Potter on August 15, 2025
Broker Licensed in FL
So my belief is that the most important thing regarding what to know about Medicare and its parts is really your enrollment windows. When you have to take a plan, when you have to take Part B, and when you don't have to take anything at all.
As far as the individual parts, Part A is the hospital coverage. It basically covers your room and board while you're in the hospital, or if you're in a skilled nursing facility. It also covers hospice as well as blood in the hospital.
Medicare Part B is known as your medical coverage. But what that really means is that it covers everything else outpatient. So those are all your doctor's visits, surgeries, blood work, EKGs, MRIs, anything that would be outpatient, including durable medical equipment.
Part C is another name for Medicare Advantage plans. Basically, you can get on a private plan and get your Medicare coverage that way. And then Part D is for prescriptions and drugs. Part D plans can be standalone, meaning that if you just stay with original Medicare and get a supplement, you're most likely gonna get a Part D plan.
However, if you decide to go on a Medicare Advantage plan, those plans typically have a prescription drug plan embedded into them already. So you do not have to choose a separate drug plan. I hope this helps.
Answered by Michael Andrews on February 3, 2026
Broker Licensed in CT
Part A covers hospital care
Part B covers doctor visits and outpatient services
Part D covers prescription drugs
Part C is Medicare Advantage; these plans combine coverage and often include extra benefits.
Medicare does not cover everything, which is why many people add additional coverage to help with out-of-pocket costs.
Answered by Jake Purvis - CMIP on February 9, 2026
Broker Licensed in FL, GA & TX
Answered by Joel Gregory Craven on August 15, 2025
Broker Licensed in MS, AL, AZ & 5 other states
Part A is for Hospital coverage. In other words, In-Patient care like hospitalization, skilled nursing & hospice care.
Part B is for Medical coverages. In other words, Part B is for Out-Patient care like office visits, ER and Urgent Care, Surgeons, labs and Ambulance services.
Most Americans have contributed enough through their employment so they have no monthly premium for Part A. Part B does pay a portion (about 20-25% of the total cost) which in 2025 is $185 per month.
Even though Medicare is good medical coverage, it is still advisable that everyone complete their coverage through a Supplement/Medigap Plan or through an Advantage Plan. Talk with an Agent/Broker to guide you through your options.
Answered by Brenda Trejos on October 6, 2025
Broker Licensed in CA, AR, AZ & 28 other states
• Part A is your Hospital Insurance
• Part B is your Doctor and Outpatient visits.
• Part C, Advantage Plans combines your Original Medicare Part A, Part B and usually includes Prescription Drug coverage into Federal plan. These plans offered through private insurance companies that are contracted with the government. Advantage plans often add benefits that Original Medicare doesn't cover, like dental, vision, hearing, and fitness.
• Part D is prescription drug coverage. They are either Stand-alone plans or included in Medicare Advantage plans, providing drug coverage. These plans help pay for prescription medications.
Answered by Pamela Camey on January 12, 2026
Broker Licensed in IL, FL, IA & 6 other states
Answered by Jorge Magana on November 30, 2025
Broker Licensed in CA & AZ
The easiest way to think about Part A is that this typically pertains to expenses associated to being an inpatient in the hospital. In other words, you have a room and I can send you flowers. It also deals with things like home health care, hospice, etc., but for simplification purposes think about it tying to an inpatient hospital stay. In most cases, Part A is premium free for individuals.
On the other hand, Part B is pretty much everything else on an outpatient basis. Think about going to see your doctors, having outpatient testing, an outpatient surgery or even outpatient chemotherapy. One of the biggest things to understand associated to Medicare Part B is that you are responsible for 20% of all costs that fall under this side of Medicare with no limit or "cap" on how much you can owe. Also, Part B has a monthly cost that is set to be $202.90 for 2026 for the average American.
We can certainly get much more in-depth but this is a good starting point for conversation.
Answered by Andrew Sandlin on December 17, 2025
Agent Licensed in IN, AL, FL & GA, IL, MI & OH
Parts A&B are referred to as… Fee For Service Medicare, Original Medicare. They were created in 1965. You may receive care from any doctor and any hospital who will accept being paid by Medicare at the Medicare Approved Amounts.
Part A. Hospital Coverage: Generally earned by paying FICA (employment taxes) for 40 qualifying quarters (like Social Security). What is important to understand is that Part A is “in-patient hospital coverage”, End of life care and some home health and skilled nursing coverage… That’s it!
Note: We have paid for Part A… IT IS NOT AN ENTITLEMENT.
Part B Medical Coverage: Generally all those other “medical” treatment options not covered in Part A above… Doctors, tests, x-rays, therapy, Dr injected part B medications, etc. Medicare pays 80% of the Medicare Approved Amount (over 13,000 procedures) and the beneficiary is responsible for the 20% Medicare doesn’t pay, including any Excess Charge billed (contact the author for further explanation). Medicare Supplement Plans (aka MediGap Plans) are 10 Medicare designed indemnity plan supplements that pay all or some of what Original Medicare doesn’t pay. Your HealthPlan is Medicare, The Supplement only pays after Medicare pays. MediGap Plans are offered by private companies and the rates are filed in each state.
Part C. Medicare Health Plans also known as Medicare Advantage (MA, MAPD, Cost & PFSS Plans). In 1996 congress created Part C. In essence, they operate similar to Employer Plans we are familiar with. Most are either HMO or PPO by design… i.e. Managed Care. Private companies are Certified and paid by Medicare to take care of beneficiaries who enroll in their plans.
Part D Prescription Drug: in 2005 Congress created Part D The Medicare Prescription Drug Plans. Private companies offer Rx coverage under Medicare guidelines.
Answered by Gregory Firmbach on September 7, 2025
Agent Licensed in FL, NJ, OH, PA & TX
Answered by Evan Hountz on January 21, 2026
Broker Licensed in OH, FL, IN, KY & TX
Answered by Sam Duffield on January 12, 2026
Broker Licensed in AL, CO, FL & 5 other states
There are four parts:
✅ Part A (80%) – Covers hospital stays, skilled nursing care, and hospice (usually free if you've worked 10+ years and paid Medicare taxes).
✅ Part B (80%) – Covers doctor visits, specialists, outpatient care, and preventive services (comes with a monthly premium, which is paid to Medicare).
✅ Part C (Medicare Advantage) – A private plan that combines Parts A and B, often includes prescription drug coverage (Part D), and extras such as dental, vision, hearing, grocery, and over-the-counter product allowances.
✅ Part D – Covers prescription drugs (available as a standalone plan or included in Part C).
You have two options if you want more coverage than the 80% provided under Medicare Parts A and B.
1. Buy a Medicare Supplement "Medigap" insurance plan with your A and B, which helps pay the deductibles and 20% coinsurance. Also, enroll in a standalone Part D plan for prescription drug coverage.
2. Enroll in a Part C (Medicare Advantage) plan.
Choosing the right coverage depends on your budget, health needs, and doctor preferences.
Our office can help you compare your options to find the best fit for your needs, and our service is free, as the insurance company compensates us.
Answered by Chad Cason on August 14, 2025
Broker Licensed in GA, AL, FL & 13 other states
Answered by Andrew Zurbuch, MBA on December 22, 2025
Broker Licensed in IN, FL, KY, MO, OH & TN
Answered by Barbara Barnes, CMIP® on August 15, 2025
Agent Licensed in PA
What does Medicare cover and not cover? To answer this question, we need to take a look at the two different parts of Medicare. Medicare has part A, which is your hospital coverage, and part B, which is your medical coverage. Part A, typically, people do not pay a premium for part A unless you did not work for at least 40 quarters within your lifetime. But part A is gonna cover your inpatient hospital care, some skilled nursing care, and hospice care. There is a deductible of $1,676 every time you go in the hospital. And if you're there more than 60 days, there's a co-pay of $419 per day. From date 91 to 150, it goes up to $838 per day. And then after that, you'll be paying for everything as it is not covered. For skilled nursing facility care, Medicare will cover you for the first 20 days, and then after that, $209.50 per day up to day 100. And then after day 100, you're not covered. So everything will be out of pocket. Your part B covers your doctor services, your outpatient services, including surgery and some other services and supplies that are not covered by part A. There is a premium for your part B. Most people will pay $185 per month, but it does go up based on your income. Part B has an annual deductible of $257. And then after that, 20% is what your co-insurance would be. So there are two different types of plans that you can get: Medicare Supplement and Medicare Advantage to cover the things that Medicare does not cover.
Answered by Chad Watkins on November 13, 2025
Agent Licensed in NJ, AK, AL & 48 other states
Answered by Rob Campbell on August 31, 2025
Broker Licensed in NC, AZ, CT & 11 other states
Answered by Joseph Ford on December 26, 2025
Agent Licensed in CA
Medicare Part A (Hospital Insurance):
Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services.
Medicare Part B (Medical Insurance):
Provides coverage for outpatient care, doctor’s services, preventive services, and some home health care.
Medicare Part C (Medicare Advantage):
Offered by private insurance companies approved by Medicare, Part C combines Parts A and B and often includes additional benefits, such as prescription drug coverage, dental, vision, and wellness programs.
Medicare Part D (Prescription Drug Coverage):
Provides coverage for prescription medications and is available through private insurers.
Understanding these parts helps beneficiaries make informed decisions regarding coverage options and out-of-pocket costs. For comprehensive details about member rights and responsibilities, you may wish to consult the Member Rights documentation.
Answered by Elijah Pannell on August 15, 2025
Agent Licensed in CA, MI, NJ & TX
Answered by Kandance Magee on October 2, 2025
Broker Licensed in LA, AL, FL, GA, MS & TX
Big picture: Original vs Advantage
Original Medicare is Part A + Part B, run by the federal government, and you can add optional Part D and/or a Medigap supplement on top.
Medicare Advantage (Part C) is an alternative run by private insurers that must cover at least what A and B cover and often wraps in Part D plus extras like dental or vision in one plan.
Core Medicare parts
Medicare piece What it is What it mainly covers
Part A “Hospital” insurance
Inpatient hospital, skilled nursing facility after a hospital stay, hospice, some home health
Part B “Medical” insurance
Doctor visits, outpatient care, tests, durable medical equipment, many preventive services
Part C Medicare Advantage
Combines A and B, usually adds extra benefits, often includes Part D in one plan
Part D Prescription drug coverage
Outpatient prescription drugs via private plans; formularies, tiers, and costs vary by plan
Medigap Supplement to Original Medicare
Helps pay A and B’s deductibles, copays, coinsurance; standardized plans like G, N in most states
Key things people should know
Eligibility and timing: Most people qualify at 65; you generally enroll in Parts A and B through Social Security and must have both A and B before joining a Medicare Advantage or Medigap plan.
Costs: Each part can have its own premiums, deductibles, and copays; Part A is often premium-free, but Part B, C, and D usually have monthly premiums that can vary by income and plan.
Coverage gaps: Original Medicare has no cap on annual out-of-pocket costs and does not include routine dental, vision, or hearing, which is why many people add Medigap and/or Part D or choose Medicare Advantage instead.
Answered by David Ghiorso on June 2, 2026
Agent Licensed in CA, AZ, IA, MT, NV & TN
It can be confusing, so I would advise you speak to someone like me, an independent agent, to help you navigate the options and help you with your choices.
Answered by Vonda Peralez on December 22, 2025
Broker Licensed in CA & WA
You also have the option to choose a Medicare Advantage plan, known as Part C. Those plans bundle your hospital, medical, and usually your drug coverage into one plan, and many include extra benefits like dental, vision, hearing, or gym memberships.
The biggest thing I tell people is this: Medicare gives you options, and understanding the parts helps you choose what fits your health needs and your budget.
Answered by Marisol Adamo on March 9, 2026
Broker Licensed in WA & OR
Answered by Jack Mayer on January 19, 2026
Agent Licensed in CA & NV
Part A: hospital coverage, $0 premium (paid by taxes) with different deductibles
Part B: doctor/specialist coverage: $202.90/month premium taken out of SS, $283 deductible, then becomes an 80/20 plan
Part C: private Medicare/Medicare Advantage, $0 premium for many plans, combined with dental/vision/hearing and a prescription plan, offered by all private carriers (Humana, BCBS, Wellcare, Aetna, etc. )
Part D: prescription drug coverage if you are on Parts A/B that you set up once you have a Medicare #, premium comes out of your SS
The rest of the parts are different types of supplements/Medigap that is offered in each state.
The rest of the information will be best to contact a local agent about.
Answered by Adam Ernst on February 1, 2026
Agent Licensed in NC, SC & TN
Answered by Charles Borg on February 2, 2026
Agent Licensed in FL & NY
Answered by John Messler on October 26, 2025
Agent Licensed in NH, ME, NC, OH, PA & TX
Answered by James Wareheim on May 18, 2026
Agent Licensed in FL, GA, NC, NV & SC
Other parts of Medicare include Part C( Medicare Advantage) and Part D( Prescription Drug Plans).
Answered by Roberto Alonso on January 19, 2026
Agent Licensed in FL
We start to notice a gap of 20% and additional copays so what we do is we pair a medi-gap plan. Also known as a medicare supplement plan. These plans fill in the gaps that medicare has.
Answered by Matthew Moreno on August 15, 2025
Broker Licensed in IL, AZ, FL, TX & VA
Part A helps with hospital stays, skilled nursing care, and hospice. Most people don’t have to pay a premium for this. Part B covers doctor visits, outpatient care, and preventive services like screenings and vaccines. There is a monthly premium for Part B.
Part C, also known as Medicare Advantage, is a plan offered by private insurance companies. It includes everything in Parts A and B, and often adds extra benefits like vision, dental, or prescription drug coverage.
Part D is prescription drug coverage. You can get it on its own if you have Original Medicare, or as part of a Medicare Advantage plan.
Some people also choose to add a Medigap plan, which helps pay for costs that Medicare doesn’t fully cover, like copays and deductibles.
Choosing the right coverage depends on your health needs and budget.
Answered by Jessica Ellis on October 2, 2025
Broker Licensed in OK
Answered by Martha Lopez-Elkind on September 29, 2025
Agent Licensed in NV
Answered by Lesley Paul on December 2, 2025
Agent Licensed in FL
Answered by Brittany Morris on December 9, 2025
Agent Licensed in LA
1. Part A – Hospital Insurance
• Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
• Most people don’t pay a premium for Part A if they (or their spouse) worked and paid Medicare taxes long enough.
2. Part B – Medical Insurance
• Covers doctor visits, outpatient care, preventive services, and medical supplies.
• You pay a monthly premium for Part B, and there’s usually a deductible and coinsurance.
3. Part C – Medicare Advantage
• These are private plans (approved by Medicare) that bundle Part A and Part B coverage, often including prescription drugs (Part D), vision, dental, and hearing benefits.
• You must have both Part A and Part B to enroll in a Part C plan.
4. Part D – Prescription Drug Coverage
• Helps cover the cost of prescription medications.
• Offered through private insurers approved by Medicare; you pay a monthly premium.
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Other important points:
• You can get coverage directly through Original Medicare (Parts A & B) or through a Medicare Advantage plan (Part C) — but not both at the same time.
• Medigap (Medicare Supplement Insurance) is optional insurance that helps pay costs Original Medicare doesn’t cover (like copayments and deductibles).
• There are specific enrollment periods each year when you can sign up or make changes.
• Medicare doesn’t usually cover long-term care, routine dental, vision, or hearing aids, unless you have a plan that includes them.
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Answered by Pedro Rodriguez on November 12, 2025
Agent Licensed in FL, CO, TN & TX
Answered by Christine Vassar on March 23, 2026
Agent Licensed in GA
Part A: Hospital Coverage
Part B: Outpatient and doctor services
Part C: Medicare Advantage (private plans combining A & B, often with extras)
Part D: Prescription Drug Coverage
Enrollment timing matters, and supplemental plans (Medigap) can help cover out of pocket costs.
Answered by Jonathan Hardy on October 13, 2025
Agent Licensed in VA, AZ, CA & 21 other states
Answered by Mueser (Sara) Kocareli on January 18, 2026
Agent Licensed in FL
Tags: New To Medicare The Medicare System
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