Ever since 1965, the United States federal government has been providing beneficiaries with health care insurance through the Medicare program. Today, there are more than 62.6 million people who rely on Medicare to assist them with their health care expenses.
You may be eligible for the Medicare health insurance program if you meet any of the following criteria:
- You are 65 or older.
- You are younger than 65 but have a qualifying disability.
- You have End-Stage Renal Disease. Regardless of age, Medicare covers those who have permanent kidney failure and need a transplant or dialysis.
Those who are eligible for Medicare can enroll in either Original Medicare or a Medicare Advantage plan to get their benefits. There are four different parts of Medicare that cover specific health care services, and this article explains a bit more about those different parts.
What are the different parts of Medicare?
There are four different parts of Medicare, A, B, C, and D. Original Medicare is divided into Part A and Part B. Medicare Advantage is Part C, and prescription drug coverage is Part D. You may be wondering what is the difference between Medicare Part A, Part B, Part C, and Part D. Let’s have a look at each part separately.
Medicare Part A
Part A is the part of Original Medicare that provides benefits for care while you are an inpatient in the hospital, a skilled nursing facility, or hospice. Part A also covers some home health care services. Part A doesn’t cover custodial or long-term care if it’s the only type of care you need while you are an inpatient. To be eligible for this coverage, the hospital or other medical facilities must accept Medicare assignment.
Medicare Part A doesn’t carry a monthly premium for most beneficiaries. If you or your spouse has worked for at least 40 quarters (approximately 10 years) and paid Medicare taxes, Part A is premium-free. There is, however, a deductible that applies to every benefit period that you receive inpatient care. And depending on the number of days you are an inpatient, you may pay coinsurance.
Medicare Part B
Part B is the second part of Original Medicare. It covers a portion of physicians’ services and your outpatient care. Part B also provides coverage for some services that Part A doesn’t cover, even if you receive them during inpatient treatment. These can include physical, occupational, and speech therapy, and certain home health care services.
To be eligible for coverage through Medicare Part B, the services or supplies you receive must be considered medically necessary, and the health care provider or supplier must accept Medicare assignment.
There is a monthly premium for Medicare Part B, as well as an annual deductible, and coinsurance or copayments. For most covered services, Medicare pays 80 percent of the final approved cost, and you are responsible for the remaining 20 percent after covering your annual deductible.
Medicare Part C/Medicare Advantage
Medicare Advantage plans are offered to eligible Medicare beneficiaries as an alternative way to get Medicare Part A and Part B benefits. These plans are sold by private insurance companies that must provide the same coverage as Parts A and B do.
Part C plans also typically offer additional coverage such as prescription drugs; and extra benefits like dental, vision, and hearing care that Original Medicare doesn’t cover. In some cases, these benefits are all bundled into one plan with one monthly premium, while others may have separate plans with multiple premiums.
Medicare Part D
Part D is prescription drug coverage. You can purchase a stand-alone Part D plan from a private insurance company that works with Medicare, or you can get prescription drug coverage bundled with your Medicare Advantage plan.
Because these plans are provided by private insurers, they have the option to create their own list of covered drugs, for the most part.
Medicare Prescription Drug Plans and Medicare Advantage plans with prescription drug coverage usually may have a monthly premium, deductible, and copayments.
What’s the difference between Medicare Part A, Part B, Part C, and Part D?
To summarize, the different parts of Original Medicare – Parts A and B – cover different types of care.
Part C is an alternate way to get the same benefits as Original Medicare Parts A and B, with additional benefits. In many instances, Medicare Advantage plans sometimes require beneficiaries to use health care providers, suppliers, and facilities that are included in the plan’s network, but Original Medicare allows beneficiaries to use any health care providers that are affiliated with Medicare and accept assignment.
Medicare Part D covers prescription drugs and each plan has its own coverage allowances, limits, and costs.
Compare the Medicare options available in your area to find the coverage that’s right for you.