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Medicare is a federal health insurance program that is designed to provide coverage for seniors who are 65 and older, as well as for those younger than 65 with qualifying disabilities and End-Stage Renal Disease (ESRD). Within Medicare are four different parts; each part consists of different types of coverage to meet the needs of different individuals. These parts include Part A, Part B, Part C, and Part D.

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Medicare Part A is Medicare’s hospital insurance plan. It will provide coverage for:

  • Inpatient care
  • Home health care
  • Skilled nursing facility care
  • Hospice care

Part A is also part of what is called Original Medicare.

Medicare Part B is Medicare’s medical insurance plan. It will provide coverage for:

  • Outpatient care
  • Medically necessary services
  • Durable medical equipment
  • Mental health services
  • Preventive services
  • Home health services

When combined with Part A, Part B will make up the second part of Original Medicare. Having both Part A and B coverage is recommended when you first become eligible so you can make the most of your Medicare coverage and avoid late enrollment penalties.

Once enrolled in Original Medicare, you will also have the option of adding on one of ten Medicare Supplement (Medigap) plans. These plans will help supplement your coverage by covering your out-of-pocket costs.

Medicare Part C is also commonly referred to as Medicare Advantage. These plans are considered to be alternative options to Original Medicare because they are required to provide the same coverage as Original Medicare. They also may offer additional benefits, which can include:

  • Prescription drug coverage
  • Dental, vision, and hearing coverage
  • Gym memberships
  • Health and wellness services
  • And more

There are also several plans within Medicare Advantage, which include:

  • Health Maintenance Organization (HMO) Plans
  • Preferred Provider Organization (PPO) Plans
  • Medical Savings Account (MSA) Plans
  • Private Fee-for-Service (PFFS) Plans
  • Special Needs Plans (SNPs)

Depending on which Medicare Advantage plan is available to you will depend on the type of extra benefits you may receive. Keep in mind that you must also be enrolled in Original Medicare before you can join a Medicare Advantage plan.

Medicare Part D will provide prescription drug coverage. You can add on a standalone Part D plan when enrolled in Original Medicare, or you can join a Medicare Advantage plan that includes prescription drug coverage as an added benefit.

Part D plans are designed to cover a wide range of prescriptions that individuals take, which includes most drugs that are considered to be in protected classes. These specific drugs can include:

  • Anticancer
  • Anticonvulsants
  • Antidepressants
  • Antipsychotics
  • HIV/AIDS
  • Immunosuppressants

The exact list of drugs that are covered will vary by plan.

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