Understanding Medicare: A Simple Guide to Parts A, B, C, and D

For Americans approaching age 65, the word “Medicare” can be overwhelming. It’s a complex system of different parts, plans, and enrollment periods. As independent brokers, our job is to make this simple.

Understanding the four basic parts of Medicare is the first step to ensuring you have the right healthcare coverage for your retirement.

What is Original Medicare? (Parts A & B)

Original Medicare is the foundational health coverage offered by the federal government. It’s broken into two parts:

## Part A: Hospital Insurance

• What it covers: This is your “inpatient” coverage. It helps pay for your stay in a hospital, skilled nursing facility care, hospice, and some home health care.
• What it costs: For most people who have paid Medicare taxes for at least 10 years, Part A is premium-free.

## Part B: Medical Insurance

• What it covers: This is your “outpatient” coverage. It helps pay for doctors’ services, preventive care (like checkups), medical supplies, and outpatient procedures.
• What it costs: Part B has a standard monthly premium (set by the government each year) and an annual deductible.

The Two Other Parts: (Parts C & D)

Original Medicare (A & B) does not cover everything. It notably does not cover most prescription drugs, dental, or vision. This is where private insurance plans come in.

## Part C: Medicare Advantage

• What it is: A Medicare Advantage plan is an all-in-one alternative to Original Medicare. These plans are offered by private companies (like Humana, Aetna, etc.) that are approved by Medicare.
• What it covers: These plans must cover everything Parts A and B cover. In addition, most Part C plans bundle in Prescription Drug (Part D) coverage, as well as extra benefits like dental, vision, and hearing—all for a low (often $0) monthly premium.
• How it works: You are still in the Medicare system, but your private plan manages your care, often through an HMO or PPO network.

## Part D: Prescription Drug Coverage

• What it is: This is a standalone plan offered by private insurers that adds drug coverage to Original Medicare (A & B).
• Who needs it: You need a Part D plan if you have Original Medicare. If you get a Medicare Advantage (Part C) plan, your drug coverage is usually already included.

The Bottom Line

You have two main paths at age 65:

1. Original Medicare (A + B) + a Part D plan + a Medigap (Supplement) plan to cover the gaps.
2. A Medicare Advantage (Part C) plan that bundles A, B, and often D, plus extra benefits.

Choosing the right path depends entirely on your budget, your health, and the doctors you want to see.

Confused? We Can Help.

As licensed brokers, we can compare every Medicare plan available in your area—at no cost to you. We’ll help you find the plan that covers your doctors and prescriptions for the lowest possible cost.