Medicare is made up of several different parts, and understanding how each one works is key to protecting yourself from life’s unexpected health care costs. While Medicare provides essential coverage, knowing what each part includes, and what it doesn’t, can help you make more informed decisions about your care.

The Parts of Medicare Explained

Medicare Part A
Part A helps cover inpatient hospital stays, hospice care, and limited skilled nursing services following hospitalization. Most people are automatically enrolled in Part A when they apply for Medicare. If you’ve worked and paid Medicare taxes for at least 10 years, you may qualify for premium-free Part A coverage.

Medicare Part B
Part B covers medical services received outside of the hospital, including doctor visits, preventive screenings, lab tests, ambulance services, and certain medical equipment used at home. After you pay the monthly premium, Part B typically covers 80% of approved costs, leaving you responsible for the remaining balance.

Medicare Part C (Medicare Advantage)
Medicare Advantage plans are offered by private insurance companies and combine Parts A and B into one all-in-one plan. Many Medicare Advantage plans also include additional benefits such as dental and vision coverage, hearing services, mobility aids, and non-emergency transportation.

Medicare Part D
Part D provides prescription drug coverage through private insurance providers. Costs and coverage vary by plan and location, with differences in premiums, deductibles, and copayments. Premiums are often income-based, making it important to compare options carefully.

Filling the Gaps in Coverage

Even with Medicare in place, out-of-pocket expenses like deductibles, copayments, and coinsurance can add up quickly. That’s where Medigap comes in. Medigap policies are designed to help cover many of these gaps in Original Medicare. While Medigap is not a Medicare Advantage plan, it can significantly reduce unexpected medical costs and provide added peace of mind.

Get Help Choosing the Right Plan

Navigating Medicare options can feel overwhelming, but you don’t have to do it alone. If you’re interested in learning more about your coverage options and finding the plan that best fits your needs, now is a great time to speak with an insurance professional at Health Plans of America. They make the process simple by connecting you with a licensed insurance agent who can guide you every step of the way.

Connect today to get started and feel confident in your Medicare coverage.

Did you know that many people don’t have a clear understanding of how Medicare works? At Health Plans of America, we believe that having accurate information is the first step toward choosing the right coverage. Let’s clear up some of the most common myths about Medicare.

Myth #1: Medicare Part B Is Free

A common misconception is that Medicare Part B comes at no cost. In reality, Part B requires a monthly premium and also includes a deductible, copayments, and coinsurance just like other parts of Medicare.

Myth #2: You Can Enroll in Medicare Anytime

Medicare enrollment is limited to specific time periods. While there are certain qualifying situations that allow for Special Enrollment Periods, most people must enroll during designated enrollment windows. Open Enrollment is a great time to review your options and sign up if you’re eligible.

Myth #3: Medicare Costs the Same for Everyone

Medicare costs can vary from person to person. Premiums, out-of-pocket expenses, and coverage differ depending on the Medicare plan you choose and the healthcare services you use.

Myth #4: Medicare Covers Everything

Unfortunately, Medicare does not cover all healthcare needs. Medicare Part A primarily covers hospital stays and inpatient care, while Part B covers doctor visits and outpatient services. Prescription drugs, dental, vision, hearing care, and fitness programs are typically not covered under Original Medicare.

Myth #5: Medicare and Medicaid Are the Same

While both are government-sponsored programs, Medicare and Medicaid serve different populations. Medicare is primarily for individuals age 65 and older or those with certain disabilities, while Medicaid assists people with limited income and resources. Medicare is federally administered, whereas Medicaid programs are run by individual states. Some individuals qualify for both programs, and this is known as being dual eligible.

---

Ready to Learn More?

Choosing the right Medicare plan doesn’t have to be confusing. Now is the perfect time to connect with an insurance professional at Health Plans of America. We make it easy by connecting you with a licensed insurance agent who can help you find the plan that best fits your needs. Contact us today to get started!