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The A, B, C of Basic Medicare
A Simple Breakdown of What You Need to Know
Navigating Medicare starts with understanding the basics. Here's a quick look at the A, B, and C of Medicare what each part covers, who’s eligible, and how it all fits together.
🅰 Medicare Part A — Hospital Insurance
What it covers:
- Inpatient hospital stays
- Skilled nursing facility care
- Hospice care
- Limited home health services
Cost: Most people don’t pay a monthly premium for Part A if they or their spouse worked and paid Medicare taxes for at least 10 years.
🅱 Medicare Part B — Medical Insurance
What it covers:
- Doctor visits and outpatient care
- Preventive services (like screenings and vaccines)
- Lab work and diagnostic testing
- Durable medical equipment
Cost: Part B requires a monthly premium, which may vary based on income. There is also an annual deductible and 20% coinsurance for most services.
🅲 Medicare Advantage (Part C) — All-in-One Option
What it includes:
- Combines Part A and Part B coverage
- Often includes prescription drug coverage (Part D)
- May offer extra benefits like vision, dental, hearing, and fitness programs
Cost & Access: Premiums vary by plan. Many offer $0 premiums. Most plans use HMO or PPO networks, so provider access may be limited based on the plan type.
Who’s Eligible?
You’re eligible for Medicare if:
- You’re 65 or older, or
- You’re under 65 and have a qualifying disability, or
- You have End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig’s Disease)
Need help deciding what’s right for you?
Our licensed advisors can help you compare plans, understand your coverage, and make confident choices about your Medicare options.
📞 Contact us today to schedule a free Medicare consultation or book an appointment .
Medicare Advantage Plans
What You Should Know About Medicare Advantage Plans (Part C):
- All-in-One Coverage: Medicare Advantage (MA) plans bundle your Medicare Part A (hospital), Part B (medical), and often Part D (prescription drugs) into a single plan offered by private insurance companies.
- Premiums Can Vary: Many MA plans have $0 monthly premiums, but you still pay your Medicare Part B premium. Some plans may have an additional premium depending on benefits and provider.
- Deductibles & Copays: These plans often have low or no deductibles, but you’ll usually pay copays or coinsurance for services like doctor visits, specialist care, or hospital stays.
- Network Type Matters: Plans are typically HMOs (you must use in-network providers and need referrals) or PPOs (more flexibility with out-of-network providers, often at a higher cost).
- Extra Benefits Included: Many plans offer vision, dental, hearing, transportation, OTC allowances, and fitness programs not covered by Original Medicare.
- Out-of-Pocket Limits: Unlike Original Medicare, Medicare Advantage plans have an annual maximum out-of-pocket limit, providing cost protection in case of major health events.