Table of ContentsView AllTable of ContentsPart A: Hospital CoveragePart B: Medical CoveragePart C: Medicare AdvantagePart D: Prescription Drug CoverageMedigapWhen to EnrollCostsWhere to Find Help
Table of ContentsView All
View All
Table of Contents
Part A: Hospital Coverage
Part B: Medical Coverage
Part C: Medicare Advantage
Part D: Prescription Drug Coverage
Medigap
When to Enroll
Costs
Where to Find Help
Medicare is a federal program that provides health insurance to senior citizens age 65 and older, and to people withqualifying disabilitiesregardless of age. To be eligible, you must be alegal U.S. residentanda U.S. citizen, or a legal resident living in the United States for at least five consecutive years, up to the month you apply for Medicare coverage.
Understanding Medicare’s parts and how they work together will help you to sign up for coverage in a way that will optimize the care you receive.
Medicare Part A: Hospital Coverage
Part A is your hospital insurance. It pays toward hospital expenses, hospice care,skilled nursing facility stays, rehabilitation facility stays, and even certain home healthcare services.
Do not assume this means everything will be paid in the long haul. Medicare hasstrict rulesthat limit how long it will cover these services, if at all.
Hospital stays can get expensive. The average cost of a three-day hospital stay is around $30,000.Thanks to Medicare, enrollees only pay a $1,632 deductible for hospital stays in 2024.
Medicare Part B: Medical Coverage
Part B is your medical insurance. It covers a variety of medical services, including healthcare provider visits,ambulance rides, preventive screening tests (e.g., for cancer and heart disease), diabetic supplies, durable medical equipment, imaging studies, laboratory tests,limited medications,vaccines, wellness visits, and more.
The bulk of health care you receive will be in the outpatient setting, meaning out of the hospital. This could be at a clinician’s office, a laboratory, a radiology facility, or any number of locations.
Even if a service is technically provided at a hospital (e.g., an X-ray is done at a hospital’s radiology department), Medicare does not consider it hospital care unless you are admitted as an inpatient.
Medicare Part C: Medicare Advantage
Medicare Advantage (Part C), formerly known as Medicare+Choice, is an alternative to Original Medicare that was added to the program in 1997. You can either choose Original Medicare (Parts A and B) or Part C. The government does not allow you to have both.
In 2023, more than 30 million Americans chose Medicare Advantage plans over Original Medicare to make sure they had extended coverage for the services they needed (e.g., dental, hearing,vision).Medicare Advantage plans come at an added cost to beneficiaries, who usually pay higher monthly premiums, deductibles, or copays than they would on Original Medicare.
In addition, there are other types of Medicare health plans. These may provide both Part A and Part B, but many provide only Part B coverage. One type is a Medicare Cost Plan, available in certain areas of the United States.
Medicare Part D: Prescription Drug Coverage
Each plan has a differentmedication formulary, and each Medicare beneficiary must decide which plan best fits their needs. No one plan covers all medications.
The National Center for Health Statistics reports that nearly half of Americans are taking at least one prescription medication, and nearly 25% are taking more than three prescriptions.It is easy to see how quickly prescription drug costs can add up.
Medicare Supplement Plans: Medigap
For those who want extra coverage, aMedicare Supplement Plan, also known as a Medigap plan, could be something to consider. These plans are not an official part of the Medicare program, though the Centers for Medicare & Medicaid Services (CMS) standardizes what they cover.
Medigap plans are the same across all states, with the exceptions of Massachusetts, Minnesota, and Wisconsin.
Medigap plans don’t actually add extra benefits to your Medicare coverage. What they do is help pay down costs that Medicare leaves on the table, like deductibles, coinsurance, and copayments.They may even add coverage when you travel overseas.
Medicare Supplement Plans
When to Enroll in Medicare
Some people may be eligible for special enrollment periods based on their employment history or other health insurance coverage they have.
There is anOpen Enrollment Periodevery year for people who want to change their Medicare coverage. If you want to, say, change from one private Medicare plan to another, or change from Original Medicare to Medicare Advantage (or vice versa), this is the time to do it.
The open enrollment period happens every year from October 15 to December 7.
Not everyone has to sign up for every part of Medicare, but not signing up on time could cost a bundle in late fees if you choose to enroll later. The late fees for Part A could last years, but Part B and Part D late penalties could last as long as you have Medicare.
For the record, choosing a Medicare Advantage plan instead of Original Medicare will not get you out of paying Part A and Part B penalties.
How Much Medicare Costs
Medicare is often referred to associalized medicine, but it isn’t free. Though it may be more affordable than some private insurance plans, many Americans struggle to afford health care.
For those who meet certain asset and income requirements, there are Medicare savings programs that may help to keep costs down.
These Medicare 2025 Changes Could Save You Money
Because Medicare is a complicated program with ever-changing rules and regulations, it can get tricky to know how to proceed.
You may want to enlist the help of your State Health Insurance Assistance Programif you have any questions or concerns about your Medicare coverage. These are volunteer-run programs that receive funding from the federal government to guide you. Alternatively, you can hire private consultants to assist you with any issues you may have.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Medicare & Medicaid Services.Original Medicare (Part A and B) eligibility and enrollment.Centers for Medicare & Medicaid Services.CMS fast facts.Centers for Medicare & Medicaid Services.Medicare program - general information.Centers for Medicare & Medicaid Services.Why health insurance is important: protection from high medical costs.Centers for Medicare & Medicaid Services.2024 Medicare Parts A & B premiums and deductibles.KFF.Medicare Advantage in 2024: enrollment update and key trends.Centers for Disease Control and Prevention.Therapeutic drug use.Centers for Medicare & Medicaid Services.What’s Medicare Supplement Insurance (Medigap)?Centers for Medicare & Medicaid Services.When does Medicare coverage start?Social Security Administration.Medicare information.Centers for Medicare & Medicaid Services.Medicare open enrollment.Centers for Medicare & Medicaid Services.Avoid late enrollment penalties.Centers for Medicare & Medicaid Services.Costs.Centers for Medicare & Medicaid Services.Monthly premium for drug plans.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Medicare & Medicaid Services.Original Medicare (Part A and B) eligibility and enrollment.Centers for Medicare & Medicaid Services.CMS fast facts.Centers for Medicare & Medicaid Services.Medicare program - general information.Centers for Medicare & Medicaid Services.Why health insurance is important: protection from high medical costs.Centers for Medicare & Medicaid Services.2024 Medicare Parts A & B premiums and deductibles.KFF.Medicare Advantage in 2024: enrollment update and key trends.Centers for Disease Control and Prevention.Therapeutic drug use.Centers for Medicare & Medicaid Services.What’s Medicare Supplement Insurance (Medigap)?Centers for Medicare & Medicaid Services.When does Medicare coverage start?Social Security Administration.Medicare information.Centers for Medicare & Medicaid Services.Medicare open enrollment.Centers for Medicare & Medicaid Services.Avoid late enrollment penalties.Centers for Medicare & Medicaid Services.Costs.Centers for Medicare & Medicaid Services.Monthly premium for drug plans.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Medicare & Medicaid Services.Original Medicare (Part A and B) eligibility and enrollment.Centers for Medicare & Medicaid Services.CMS fast facts.Centers for Medicare & Medicaid Services.Medicare program - general information.Centers for Medicare & Medicaid Services.Why health insurance is important: protection from high medical costs.Centers for Medicare & Medicaid Services.2024 Medicare Parts A & B premiums and deductibles.KFF.Medicare Advantage in 2024: enrollment update and key trends.Centers for Disease Control and Prevention.Therapeutic drug use.Centers for Medicare & Medicaid Services.What’s Medicare Supplement Insurance (Medigap)?Centers for Medicare & Medicaid Services.When does Medicare coverage start?Social Security Administration.Medicare information.Centers for Medicare & Medicaid Services.Medicare open enrollment.Centers for Medicare & Medicaid Services.Avoid late enrollment penalties.Centers for Medicare & Medicaid Services.Costs.Centers for Medicare & Medicaid Services.Monthly premium for drug plans.
Centers for Medicare & Medicaid Services.Original Medicare (Part A and B) eligibility and enrollment.
Centers for Medicare & Medicaid Services.CMS fast facts.
Centers for Medicare & Medicaid Services.Medicare program - general information.
Centers for Medicare & Medicaid Services.Why health insurance is important: protection from high medical costs.
Centers for Medicare & Medicaid Services.2024 Medicare Parts A & B premiums and deductibles.
KFF.Medicare Advantage in 2024: enrollment update and key trends.
Centers for Disease Control and Prevention.Therapeutic drug use.
Centers for Medicare & Medicaid Services.What’s Medicare Supplement Insurance (Medigap)?
Centers for Medicare & Medicaid Services.When does Medicare coverage start?
Social Security Administration.Medicare information.
Centers for Medicare & Medicaid Services.Medicare open enrollment.
Centers for Medicare & Medicaid Services.Avoid late enrollment penalties.
Centers for Medicare & Medicaid Services.Costs.
Centers for Medicare & Medicaid Services.Monthly premium for drug plans.
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