What are the parts of Medicare? And what do they cover?

Here are some basic facts to get you started learning about Medicare and what it covers.

When I first started my career in the Medicare world, I realized there was a lot of new information I had to learn. I found that breaking it down into bite-sized pieces made it easier to understand. I started by focusing on all the different parts of Medicare. Here are some tips that helped me understand the parts of Medicare and what they cover.

What is Medicare?

Medicare is a federal health insurance program. You can get Medicare if you’re age 65 and older. You can also get Medicare at age 18 or older if you’re disabled or have end-stage renal disease. The Medicare program offers basic coverage to help pay for things like doctor visits, hospital stays and surgeries.

What are the parts of Medicare?

Medicare is broken out into four parts. 

  1. Medicare Part A
  2. Medicare Part B
  3. Medicare Part C
  4. Medicare Part D

What does Medicare cover?

The parts of Medicare cover different services:

Medicare Part A

Part A (hospital coverage) covers things like inpatient hospital stays, some home health care and skilled nursing facility care. Together, Medicare Parts A and B are called “Original Medicare.”

Medicare Part B

Part B (medical coverage) covers things like doctor visits, outpatient services, X-rays and lab tests, and preventive screenings.

Medicare Part C

Part C is also known as Medicare Advantage. Private health insurance companies offer these plans. When you join a Medicare Advantage plan, you still have Medicare. The difference is the plan covers and pays for your services instead of Original Medicare. These plans must provide the same coverage as Original Medicare (so you’re not missing out on anything). They can also offer extra benefits.

Medicare Part D

Part D covers prescription drugs. Only private health plans offer it. You can get a separate Part D plan or sometimes it’s included in a Medicare Advantage plan.

Does Medicare cover these services?

Here’s general info about what Medicare does or doesn’t cover for common health care needs. Visit medicare.gov/coverage for more detail. Also, check a Medicare Advantage plan’s Summary of Benefits to learn what’s covered.

Acupuncture
Assisted living
Cataracts surgery
Chiropractic care
Colonoscopies
Eye exams
Eyeglasses or contacts for vision
Hearing aids
Home health care
Hospice care
Physical therapy

When can I get Medicare?

There are a few different times you can enroll throughout the year. These are called enrollment periods.

Check out the visual below to see when you can enroll, read our blog post When and how to apply for Medicare, or visit medicare.gov for more information.

[Click on the image to see the full version]

medicare-parts-explained

 

WANT TO KEEP LEARNING HOW MEDICARE WORKS?

Check out this introduction to Medicare basics video.