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Medicare Parts Explained

| August 24, 2023

Medicare can be complicated to sort through; many options and choices are available to suit different needs. To make it simpler, the program has been broken down into four basic parts. As you think about how Medicare will cover your health care needs, one of the major decisions will be whether to enroll in federally run Original Medicare or select a Medicare Advantage plan, the private insurance alternative.

For most individuals, knowing which parts to enroll in can be difficult to determine so here is an overview of each plan:

Part A – Hospital Coverage: This covers inpatient hospital stays, hospice care, and qualified nursing care that individuals may need after suffering a serious health issue or injury that requires rehabilitation or short-term nursing care.

Part B – Doctor and Outpatient Services: Includes routine doctor visits, lab tests, preventive medicine, medical equipment, ambulance transportation, x-rays, and some outpatient prescription drugs.

Part C – Medicare Advantage: Medical Health Plans for purchase through private insurers that contract with Medicare to provide at least all of the services offered in Part A and B with additional offerings such as dental, vision, hearing, or prescription drug coverage. The coverage and cost vary from plan to plan.

Part D – Prescription Drug Plan: Drug insurance plans purchased through private insurers are designed to help cover prescription medication costs. The types of medications covered are determined by a formulary published by the federal government that is subject to change every year. Part D plans cover both generic and name-brand medications, with limitations. Some medications aren’t covered; in that event, an exception can be filed, but there is no guarantee it will be granted.

The key to Medicare is to determine the Medicare coverage choices that work for your healthcare needs and budget. If you have questions about planning for retirement healthcare costs, please don’t hesitate to reach out. We’re always here to answer your questions or address your concerns.