What Is Medicare?

Medicare is a federal health insurance program in the United States primarily designed for:

People age 65 and older
Certain younger individuals with disabilities
People with End-Stage Renal Disease (ESRD) or ALS

Medicare is divided into different “parts,” each covering specific healthcare services.

Medicare Part A: Hospital Insurance

Medicare Part A helps cover costs related to inpatient care. It generally includes:

Hospital stays
Skilled nursing facility care (not long-term care)
Hospice care
Limited home health services

Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working. However, deductibles and copayments may still apply.

Medicare Part B: Medical Insurance

Medicare Part B covers outpatient and preventive services, such as:

Doctor visits
Preventive care (vaccines, screenings, annual wellness visits)
Medical equipment (wheelchairs, walkers)
Outpatient services and lab tests

Part B requires a monthly premium, which can vary based on income. It also includes an annual deductible and typically covers about 80% of approved medical costs, with the remaining 20% paid by the beneficiary or supplemental insurance.

Medicare Part C: Medicare Advantage

Medicare Part C, also known as Medicare Advantage, is offered by private insurance companies approved by Medicare. These plans combine:

Part A (hospital)
Part B (medical)
Often Part D (prescription drugs)

Many Medicare Advantage plans may also include extra benefits, such as:

Dental, vision, and hearing coverage
Fitness programs
Wellness benefits

Costs, coverage, and provider networks vary by plan, and members usually must use network providers.

Medicare Part D: Prescription Drug Coverage

Medicare Part D helps cover the cost of prescription medications. It is offered through private insurance companies and can be added to:

Original Medicare (Parts A and B)
Some Medicare Advantage plans

Each Part D plan has its own list of covered drugs (formulary), premiums, copays, and pharmacy networks.

Understanding the different parts of Medicare can help individuals choose the coverage that best fits their healthcare needs and budget. Whether someone prefers Original Medicare or a Medicare Advantage plan, knowing what each part covers is an important step toward making informed healthcare decisions.