Introduction to Medicare

The Four Parts of Medicare — What you can expect from Medicare

Medicare has four parts — Part A, Part B, Part C, Part D. 

Parts A and B are known as Original Medicare. They cover some, but not all, healthcare expenses.

Part A — Hospital Insurance

Part A covers hospital inpatient care if you are hospitalized. Part A also covers some skilled nursing facility, home health and hospice care.  If you are entitled to Part A, there is no monthly or annual premium charge, but there is a charge for inpatient hospital stays and related health care services like doctor visits associated with hospitalization.

Part B — Medical Insurance

Part B pays for doctors’ services, outpatient hospital care and home health visits not covered under Part A. It also covers laboratory tests such as X-rays and blood work, medical equipment such as wheelchairs and walkers, preventive services such as mammograms and prostate cancer screenings, cardiovascular (heart) disease and diabetes screenings, outpatient physical therapy, mental health care and ambulance services.

If enrolled in Part B, you must pay a monthly premium, which is typically deducted from your Social Security check. Medicare Part B also has an annual deductible.

NOTE: Some people who have Original Medicare (Parts A & B) choose to purchase a Medicare Supplement policy, also known as a Medigap policy. These policies, sold by private insurance companies, help cover some of the costs not covered by Original Medicare such as deductibles, copayments and coinsurance. Medicare Supplement policies may also provide coverage for some services not provided by Original Medicare. You will pay a premium for these policies.

Part C — Medicare Advantage

Medicare Part C is the name for Medicare Advantage plans that include Parts A and B benefits, and may offer additional benefits or services. Some Part C plans also provide coverage for prescription drugs (described below). Medicare Advantage plans are run by Medicare approved private insurance companies. Monthly premiums may be charged for the coverage provided by these plans.

Part D — Prescription Drug Coverage

Help to cover the cost of prescription drugs is provided by Part D. Medicare drug coverage is offered through two types of Medicare-approved private plans. Plans that provide prescription drug coverage only are called Prescription Drug Plans. Medicare Advantage plans that include prescription drug coverage in addition to medical coverage are called Medicare Advantage Prescription Drug Plans. Both of these types of plans may charge a monthly premium.

Help that could reduce or eliminate premiums, deductibles, and/or copayments/coinsurance for prescription drug coverage is available for Medicare beneficiaries with limited income and resources.

For more detailed information about Medicare, view our free Medicare Decision Guide

For information about the Medicare Advantage Prescription Drug plans offered by Optima Medicare HMO, request a free Optima Medicare Enrollment Guide.

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