Part A
Hospital Insurance
Helps cover inpatient hospital care, skilled nursing facility care, hospice care, and certain home health services.
EDUCATION TODAY. A BRIGHTER TOMORROW.
Medicare Made Simple
Understanding the 4 Parts of Medicare
Medicare is easier to understand when you break it into four basic parts. Each part covers something different.
Part B
Medical Insurance
Helps cover doctor visits, outpatient care, preventive services, medical equipment, and other medically necessary services.
Part C
Medicare Advantage
An alternative way to receive your Part A and Part B benefits through a Medicare-approved private insurance company. Many plans also include Part D prescription drug coverage and additional benefits.
Part D
Prescription Drug Coverage
Helps cover prescription drugs you take at home. Part D plans are offered by private insurance companies approved by Medicare.
The easiest way to remember it:
|
A = Hospital
|
B = Doctors
|
C = Medicare Advantage
|
D = Prescription Drugs
Original Medicare
How Parts A & B Work Together
Original Medicare consists of Part A (Hospital Insurance) and Part B (Medical Insurance). Together, they cover a wide range of healthcare services, but they don’t cover everything.
Part A
Hospital Insurance
- Inpatient hospital care
- Skilled nursing facility care
- Hospice care
- Certain home health services
+
Part B
Medical Insurance
- Doctor visits
- Outpatient care
- Preventive services
- Medical equipment
- Other medically necessary services
=
Original
Medicare
Part A + Part B
Original Medicare covers many healthcare services, but it generally does not cover all costs. You may still be responsible for deductibles, coinsurance, and copayments.
The Bottom Line
Part A and Part B give you a strong foundation, but most people need an additional solution to help with the out-of-pocket costs that Original Medicare doesn’t cover.
You Have Choices
There are different ways to help cover the costs that Original Medicare doesn’t pay. We’ll walk you through your options so you can choose what’s best for your health and your budget.
What Original Medicare Doesn't Cover
Original Medicare Covers a Lot.
But Not Everything.
Parts A and B provide a strong foundation, but there are important costs and services Original Medicare generally doesn't cover.
No Annual Out-of-Pocket Maximum
Original Medicare has no annual limit on what you might pay out of pocket for covered Part A and Part B services.
Deductibles & Coinsurance
Original Medicare includes deductibles and cost sharing. For Part B services, you generally pay 20% of the Medicare-approved amount after meeting the Part B deductible.
Routine Dental,
Vision & Hearing
Original Medicare generally does not cover routine dental care, routine eye exams for glasses, hearing exams, or hearing aids.
Most Prescription Drugs
Original Medicare generally does not cover prescription drugs you take at home. Drug coverage is usually obtained separately through Medicare Part D or included with many Medicare Advantage plans.
So How Do You Fill The Gaps
That’s where your Medicare choices come in. You can keep Original Medicare and add additional coverage, or choose a Medicare Advantage plan as another way to receive your Medicare benefits.
Your Medicare Options
Two Main Ways to Get Your Medicare Coverage
Once you have Parts A and B, you generally have two paths for how you receive and supplement your Medicare coverage.
Original Medicare Path
Keep Original Medicare and Add Coverage
Part A
Hospital Insurance
+
Part B
Medical Insurance
Then Add Coverage as Needed
Medicare
Supplement
Helps pay certain out-of-pocket costs Original Medicare doesn't cover.
+
Part D
Helps cover prescription drugs you get at a pharmacy or through mail order.
KEY ADVANTAGE
You generally have broad access to doctors and hospitals nationwide that accept Medicare.
OR
Medicare Advantage Path
An Alternative Way to Get Your Medicare Benefits
Medicare Advantage
Part C
Receive your Medicare benefits through a private insurance company approved by Medicare.
OFTEN INCLUDES:
Part A + Part B
Your hospital and medical benefits.
Prescription Drug Coverage
Many Medicare Advantage plans include
Part D drug coverage.
Additional Benefits May Be Included
Some plans include dental, vision,
hearing, and other benefits.
IMPORTANT TO KNOW
Plans typically use provider networks and have their own costs, rules, and annual out-of-pocket limits.
Which Path Is Right For You?
There isn’t one Medicare option that fits everyone. Your doctors, prescriptions, travel, healthcare needs, budget, and preferences all matter.
Compare Your Options
Original Medicare + Medicare Supplement (Medigap) vs. Medicare Advantage
Both options provide valuable coverage. Here’s how they compare in the areas that matter most.
Original Medicare + Medigap
Part A + Part B + Medicare Supplement
(+ Part D for prescription drugs)
(+ Part D for prescription drugs)
Medicare Advantage
Part C
(Usually includes Part A, Part B, and often Part D)
(Usually includes Part A, Part B, and often Part D)
Doctors & Hospitals
Original + Medigap
Broad nationwide access
See any doctor or hospital that participates in Medicare
and is accepting Medicare patients.
Medicare Advantage
Typically uses a provider network
Network rules vary by plan. Some plans offer
out-of-network coverage.
Monthly Costs
Original + Medigap
Usually higher monthly premiums
You pay for the additional Medigap coverage and
typically a separate Part D plan.
Medicare Advantage
Often lower plan premiums
You generally pay copays or coinsurance as you use
healthcare services.
Out-of-Pocket Costs
Original + Medigap
Helps make costs more predictable
Medigap helps pay certain deductibles, copayments,
and coinsurance left by Original Medicare.
Medicare Advantage
Costs occur as you use care
You pay the plan’s copays and coinsurance up to its
annual out-of-pocket maximum for covered Part A and
Part B services.
Prescription Drugs
Original + Medigap
Separate Part D plan
Medigap does not include outpatient prescription drug
coverage. You generally add a Part D plan.
Medicare Advantage
Often included
Many Medicare Advantage plans include Part D
prescription drug coverage.
Dental, Vision & Hearing
Original + Medigap
Usually separate
Original Medicare and standard Medigap plans generally
do not include routine dental, vision, or hearing benefits.
Medicare Advantage
Often includes additional benefits
Many plans include some dental, vision, or hearing
benefits. Coverage and limits vary by plan.
Travel
Original + Medigap
Broad U.S. access
Use Medicare-participating providers nationwide.
Some Medigap plans also provide limited foreign
travel emergency benefits.
Medicare Advantage
Service-area rules matter
Non-emergency coverage outside the plan’s service
area varies. Emergency and urgently needed care
have different rules.
Prior Authorization
Original + Medigap
Generally used less often
Original Medicare does not require prior authorization
for most services, although certain services and
programs have requirements.
Medicare Advantage
Used for some services
Medicare Advantage plans use prior authorization
for certain services according to the plan’s rules.
Cost Predictability
Original + Medigap
Generally more predictable
A Medigap plan may reduce many of the variable
out-of-pocket costs associated with Original Medicare.
Medicare Advantage
Costs depend more on healthcare use
Copays and coinsurance vary by plan and service,
subject to the plan’s annual out-of-pocket maximum.
Which Path Fits Your Priorities?
There isn’t one Medicare option that fits everyone. Your doctors, prescriptions, travel, healthcare needs, budget, and preferences all matter.
YOUR MEDICARE BLUEPRINT
You Don’t Have to Figure This Out on Your Own
Your Medicare decision is personal. We help you compare your options based on the things that matter most to you.
✓
Your Doctors
✓
Your Prescriptions
✓
Your Healthcare Needs
✓
Your Budget & Preferences
We’ll review the Medicare options available to you, answer your questions, and help you make an informed decision.
Education Today. A Brighter Tomorrow.
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