Understanding the Basics of Medicare: Parts A, B, D, and More
By Daniel Leonard – Carolina Advantage (336) 705-3294
Navigating Medicare for the first time, or even revisiting it during the annual enrollment period, can feel overwhelming. As someone who helps people through this process every day, I want to give you a clear, straightforward overview of the basics: Medicare Parts A, B, and D, along with a quick look at Medicare Advantage (Part C) and Medicare Supplement plans and why they are important.
Medicare Part A – Hospital Insurance
Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services. Most people qualify for premium-free Part A if they or their spouse paid Medicare taxes while working for at least 10 years.
While Part A helps cover many hospital-related costs, it doesn’t cover everything. For example, there are big deductibles and other costs associated with Part A.
Medicare Part B – Medical Insurance
Part B covers outpatient services like doctor visits, preventive care, lab work, X-rays, durable medical equipment, and some home health services. Unlike Part A, Part B requires a monthly premium, which is based on your income. (Standard 2025 Part B Premium: $185/mo)
It’s important to enroll in Part B when you’re first eligible, or you could face late enrollment penalties. Also, just like Part A, there are deductibles and a 20% coinsurance for most services, with no cap.
Medicare Part D – Prescription Drug Coverage
Part D is your prescription drug coverage, offered through private insurance companies approved by Medicare. These plans vary by cost and formulary (the list of covered drugs), so it's essential to choose one that fits your specific medication needs.
Even if you don’t take medications now, enrolling when you’re first eligible helps avoid a lifetime late enrollment penalty later.
Quick Look: Medicare Advantage (Part C)
Medicare Advantage plans, also known as Part C, are offered by private insurers and combine your Part A and B coverage into one plan. Many also include Part D drug coverage and extra benefits like vision, dental, hearing, fitness programs, and even transportation services.
These plans often come with lower premiums or even $0, but you’ll typically work within a network of providers. Each plan is different, so it’s important to talk to a local agent about your options.
Quick Look: Medicare Supplement Plans (Medigap)
Medicare Supplement Insurance, or Medigap, helps pay the out-of-pocket costs not covered by Original Medicare (Parts A and B), like deductibles, copays, and coinsurance. These plans offer more predictable out-of-pocket costs and allow you to see any provider that accepts Medicare—no networks!
However, Medigap plans do not include prescription drug coverage, so you’ll need a separate Part D plan if you go this route. Also, Medicare Supplement premiums will increase every year.
