Part A – Hospital Coverage
Part A covers : Inpatient hospital stays, skilled nursing facility expenses, hospice care, and some home health care.
You pay: If you or your spouse worked for 10 years and paid Medicare taxes, you will not have a monthly premium for Part A.
Part B – Covers your doctor visits and more
Part B covers : Doctor and other health care provider services, outpatient care, lab and x-ray services, ambulance services, medical supplies, and preventive services.
You pay: A monthly premium with a yearly deductible before coverage begins. Your monthly premium is calculated based on your adjusted gross income.
Parts A and B together provide coverage both in and out of the hospital.
Part C—Medicare Advantage
After you enroll in Parts A and B, you have the option to enroll in Part C. Also known as Medicare Advantage, Part C is offered through private insurance companies and combines your Part A, Part B, and sometimes Part D benefits into one easy-to-use plan.
Part C covers : Everything that Original Medicare covers and usually more. Some of the most common Medicare Advantage benefits include:
- Dental, vision, and hearing coverage.
- Fitness memberships.
- Allowance for health care products.
You pay: Once enrolled in a Medicare Advantage plan, you continue to pay your Part B premium to Medicare. You may also have a premium for your Medicare Advantage plan, which you pay to the company you are insured by.
Each drug on our Part D formulary belongs to a tier, which determines how much you will pay. As your spending during the year increases, you move through the stages of Part D coverage.
Part D—Prescription drug coverage
Part D covers : Brand-name, generic, and specialty medications. Each plan has a list of drugs it covers, known as a formulary.
You pay: The monthly premium for your Medicare Advantage Plan, which includes Part D coverage or your standalone Part D plan (if applicable). You also pay out-of-pocket costs such as copays, deductibles, and coinsurance included with the plan you choose.
Part D penalty (late enrollment penalty) : A late enrollment penalty on your Part D premium, applies if you did not have Medicare drug coverage or creditable coverage for more than 2 months since becoming eligible for Medicare. This penalty will be added to your monthly premium.