Medicare Part A, B, C, and D
Understanding Medicare Part A, B, C, and D
Medicare can be very confusing for first timers so we’ll try to sum it up in as few words as possible. First and foremost there are four main Parts of Medicare – Part A, Part B, Part C, and Part D
Part A, and Part B are essential. Then there is Part C, (Which is also called Medicare Advantage) and Part D (which is the Medicare drug Coverage).
Medicare Part A
Covers Hospital stays. (See Medicare Part A page for more details)
Medicare Part B
Covers other Medical items like Dr’s. visits, testing, and a large volume of other medical services that are not “Hospital”. (Medicare Part B Page)
Once you become eligible you will first be enrolled in:
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Medicare Part A – Hospital Insurance
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Medicare Part B – Medical Insurance
These first 2 parts of Medicare are standard for everyone who is 65 or otherwise eligible. Note: If you plan to continue to work and will be covered under an employer health care plan (or a spouses) you should defer Part "B".
Then you will need to choose a Medicare Part D Prescription Drug Coverage with the choice of one of these two options:
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Medicare Part C – Medicare Advantage (MA) alone or a Medicare Advantage plan with Rx. (MAPD). Another choice many select instead of getting a “Medicare Advantage” plan you may want to select a …
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Medicare Supplemental Insurance a.k.a. "Medigap" plan along with a stand alone Medicare Rx Plan. This is the best combination of coverage for those on Medicare. It in most cases may cost a little more than a Medicare Advantage plan but will provide better coverage, have no networks, and have none or very few co-pays compared to a Medicare Advantage plan.
Note: This is illustrated on page 43 of the CMS Medicare & You Booklet
Medicare Part C
Part C is the section in Medicare for “Medicare Advantage” plans which are the privatized version of Medicare “Part A” and “Part B”. Thinking of it another way – Medicare Part C=A+B, and it may or may not integrate Part D. The big difference it is offered by private insurers, not the government.
With Medicare Part C – Medicare Advantage – you are technically still enrolled in Medicare A, and B. However, all of your Medical bills are now covered by the private insurer and no longer covered by the federal government agency CMS – Center for Medicare and Medicaid Services.
Medicare Part “D”
Medicare Part D is also only offered by private insurers although it must be approved by the government. Part D will either be integrated into your Part C – Medicare Advantage plan – or offered as a stand-alone Rx plan primarily for people on a Medicare Supplement Insurance plan.
Medicare Supplement Insurance
Medicare Supplement Insurance also known as Medigap does not cover MORE or additional services than Medicare however it does cover the remaining financial costs associated with health care for individual beneficiaries who also have Medicare "A" and "B". For example: Medicare Supplement Insurance Plans provide coverage for some or all (Depending on the plan) of the unpaid medical charges (Deductibles and Co-insurance) not covered by Medicare Part A and Part B, but would not cover something like dental that is not covered by Medicare.
It is important to note that you can not get a Medicare Supplement plan with a Medicare Advantage plan. Medicare Advantage is designed as a stand-alone replacement for Part A and Part B, and Medicare Supplements are designed to “supplement” and pay the cost not paid by Medicare. I.E. the “Gap” between what Medicare pays for services and the cost a provider charges and is allowed by Medicare.
