Let's Break Down Medicare
Lets Break Down The Basics
Original Medicare is a fee-for-service health plan that has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance).
Part A helps cover:
• Inpatient care in hospitals
• Skilled nursing facility care
• Hospice care
• Home health care
You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working for a certain amount of time. This is sometimes called premium-free Part A. If you aren’t eligible for premium-free Part A, you may be able to buy Part A.
Part B helps cover:
• Services from doctors and other health care providers
• Outpatient care
• Home health care
• Durable medical equipment (DME) (like wheelchairs, walkers, hospital beds, and other equipment)
• Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)
Most people pay the standard Part B premium amount.
Medicare Advantage (also known as Part C):
• An “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.
• Plans may have lower out-of-pocket costs than Original Medicare.
• Most plans offer extra benefits that Original Medicare doesn’t cover— like vision, hearing, and dental services.
Part D (prescription drug coverage):
• Helps cover the cost of prescription drugs (including many recommended shots or vaccines)
• Run by private insurance companies that follow rules set by Medicare
• May help lower your drug costs and help protect against higher costs in the future
Medicaid is a joint federal and state program that helps pay medical costs if you have limited income and/or resources and meet other requirements. People with Medicaid may get coverage for services that Medicare doesn’t cover or only partially covers, like nursing home care, personal care, transportation to medical services, home- and community-based services, and dental, vision, and hearing services.