What is Medicare?
Medicare is a federal health insurance program primarily for people aged 65 and older. It’s also available to certain younger individuals with disabilities or those with end-stage renal disease (ESRD). For most people, Medicare becomes a crucial part of their healthcare coverage as they retire or lose employer-sponsored insurance.
If you’ve worked and paid Medicare taxes for at least 10 years (40 quarters), you’ll typically qualify for Medicare at age 65.
The Four Parts of Medicare Coverage
Medicare is made up of four distinct parts: Part A, Part B, Part C, and Part D. Each one covers different aspects of your healthcare.
What is Medicare Part A?
Part A is often called hospital insurance. It helps pay for:
- Hospital stays
- Skilled nursing facility care
- Hospice care
- Some home health care
If you’ve paid Medicare taxes while working, Part A is typically premium-free.
What is Medicare Part B?
Part B is medical insurance. It helps cover:
- Doctor visits
- Lab tests
- Preventative care (like flu shots)
- Outpatient services
- Durable medical equipment (DME)
Part B usually requires a monthly premium.
What is Medicare Part C?
Also known as Medicare Advantage, Part C plans are offered by private insurance companies. They bundle Part A and B coverage, and often include extras like vision, dental, and even prescription drug coverage. These plans must cover everything Original Medicare does—but with potential added benefits.
What is Medicare Part D?
Part D provides prescription drug coverage. Plans are offered by private insurers and help reduce the cost of medications. You can join a standalone Part D plan or get drug coverage through a Medicare Advantage plan that includes it.
What’s Covered Under Each Part?
Medicare part A covers:
- Inpatient hospital stays
- Semi-private rooms and hospital meals
- Skilled nursing care (not long-term care)
- Hospice services
- Some home health services
Medicare part B covers:
- Doctor visits (in and out of the hospital)
- Lab work, x-rays, and imaging
- Preventive screenings and vaccines
- Outpatient surgeries
- Ambulance rides
- Mental health care
- Durable medical equipment (wheelchairs, walkers, etc.)
Need Help Navigating Medicare?
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