Parts and Plan Types

Original Medicare

     Medicare Part A (Hospital Insurance)

Part A helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits. Most people don’t pay for Part A because they or a spouse already paid for it through their payroll taxes while working.

     Medicare Part B (Medical Insurance)

Part B helps cover doctors’ services and outpatient care. It also may cover some other medical services that Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. 

Medicare Supplement Insurance Plans

A Medicare Supplement Insurance (Medigap) is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance policy can help pay some of the remaining health care costs, like:

• Copayments
• Coinsurance
• Deductibles

Medicare Advantage Plans (Medicare Part C)

• A Medicare Advantage Plan is another health plan option. Medicare Advantage Plans, sometimes called “Part C” are offered by private insurance companies approved by Medicare. 
• If you enroll in a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage.  Medicare Advantage Prescription Drug Plans (MA-PD) also include Medicare Part D prescription drug coverage. 
• Original Medicare pays a fixed amount for your care every month to the insurance companies offering Medicare Advantage Plans. These insurance companies must follow rules set by Original Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that are within the plans network for non‑emergency or non-urgent care). These rules can change each year.

Medicare Prescription Drug Coverage (Medicare Part D)

To get Medicare prescription drug coverage, people must enroll in a plan approved by Original Medicare with prescription drug benefits. Speak with a licensed insurance agent to discuss coverage options.