The Different Parts of Medicare

Medicare vs. Medicaid

Medicare is a federal health insurance program that covers people over age 65. Those under 65 who have specific disabilities or end-stage kidney disease can also be eligible for Medicare, which covers both inpatient and outpatient services.

Medicare is different than Medicaid. Medicaid is funded and run by the federal government in partnership with states to cover people of all ages with limited incomes. While Medicare is the same everywhere in the United States, Medicaid programs may be different from state to state.

The Parts of Medicare

Medicare is divided into different parts to cover specific services.

Part A covers inpatient/hospital benefits for:

• Hospital services
• Inpatient care at a skilled nursing facility
• Inpatient rehabilitation
• Home health care
• Hospice care

Part B covers services and supplies that don't require hospitalization, such as:

• Doctor visits
• Outpatient treatment
• Preventive care services (screenings and checkups)
• Durable medical equipment (including diabetes supplies)
• Ambulance services
• Mental health services

Important: Part A and Part B together are known as “Original Medicare.”

Part C is more commonly known as Medicare Advantage plans.

Medicare Advantage plans include all the benefits covered under Part A and Part B and more. Depending on the plan you choose, it can also:

• Include prescription drug coverage
• Offer added services/programs
• Have lower out-of-pocket costs than Original Medicare alone
• Include a yearly limit on your out-of-pocket costs
• Once reached, you'll pay $0 for covered care

These plans are offered through private insurance companies. You need to have Medicare Part A and Part B to enroll in a Medicare Advantage plan. That means you’ll still need to pay your Part B premium.

Part D refers to Medicare prescription drug benefits.

These benefits are offered as part of a Medicare Advantage plan (Part C) or as a standalone prescription drug plan.

• In most cases, you can only have a standalone Medicare Part D plan if you have Original Medicare (Medicare Parts A and B) and are not enrolled in a Medicare Advantage plan.

What about Medicare Supplement (Medigap) plans?

A Medicare Supplement plan is also offered by private insurance companies. These plans help pay for costs not covered by Medicare Part A and Part B. Each plan is labeled with a different letter and offers standardized benefits. That means that one company's Plan N must offer the same benefits as another company's Plan N.

You cannot enroll in a Medicare Supplement plan if you are enrolled in a Medicare Advantage (Part C) plan.

If you still have questions, Medicare.gov has more info about all the parts of Medicare.