Medicare Parts A, B, C and D: Costs and Coverage Explained

    If you or a loved one is enrolled in Medicare, you’re probably wondering how much it will cost and what you are getting for the money. It can be hard to understand Medicare and all its facets. The following post will summarize each Part of Medicare and explain some key points to remember. It is a long post, so read through it to get the gist of each part. We’re going to start with Part A.

    Part A: Hospital Insurance

    What Is Hospital Insurance?

    “Hospital Insurance” is commonly referred to as “Traditional Medicare.” It is essential coverage for hospital care and only hospital care. If you are hospitalized and need skilled nursing, rehabilitation, post-hospital extended care, etc., you will not cover your care and costs under Part A. It is the first Part of Medicare most people think of when they talk about their coverage.

    What Does It Cover?

    Hospital Insurance covers almost every hospital service you can think of and a few others. It does not cover dental or vision care, paying for eye patch use, prescription drugs, or doctor services. Part A also does not pay for air ambulance services, hospital outpatient charges, or transfusions.

    What It Costs:

    If enrolled in Traditional Medicare, you will be assigned a ‘deductible’ for each Part of Medicare. The deductible is the portion you are responsible for paying, and only the first 30 days of your hospital stay will fall under your deductible. The majority of patients do not pay a monthly fee for Part A. Sometimes called “premium-free Part A.” If you choose Part A, you will pay up to $499 each month in 2022. The regular Part A cost would be $499 if you paid Medicare taxes for less than 30 quarters. The typical Part A cost would be $274 if you paid Medicare taxes for 30-39 quarters.

    After meeting your deductible each year, Medicare will cover 100% of your hospital costs and expenses – but only up to a certain amount that varies depending on where you live.

    Part B: Medical Insurance

    What Is Medical Insurance?

    “Medical Insurance” is known as “Supplemental Medicare” or “Medi-Gap.” This part of Medicare covers payments for medical services unrelated to your hospital care. These include doctor visits and preventive care, wellness care, outpatient hospital stays, some other care you might need in a skilled nursing facility following a hospital stay, home health costs, prescription drugs, and durable medical equipment.

    What Does It Cover?

    Part B covers doctor visits, diagnostic and screening tests, lab procedures, and a few other services. It also covers care in short-term rehabilitation facilities, inpatient skilled nursing facility stays, hospice care, home health care, and other costs related to home healthcare. 

    What It Costs:

    The typical Part B premium is $170.10 or higher, depending on your income. After you’ve met your deductible, you usually pay 20% of the Medicare-Approved Amount for most doctor services, including most doctor services. At the same time, you’re hospitalized, outpatient treatment, and durable medical equipment, DME.

    Part C: Medicare Advantage

    What Is Medicare Advantage?

    Medicare Advantage, MA, is the second way to receive Medicare coverage after Traditional Medicare. MA plans are offered through private insurance companies and are not bound to any particular rules or regulations. They can charge whatever they want for their coverage, as do all private insurance plans. 

    What Does It Cover?

    Your insurance company is the one that determines what services are covered with your plan, though Medicare will monitor certain services to make sure they are being used for approved purposes. As with Part A, Part C will cover all hospital services. It also includes outpatient hospital costs and procedures, mental health services, and other care related to your injury or illness.

    What It Costs:

    The cost of Part C will vary depending on the MA plan you choose. Some plans will cover 100% of all costs, including those that fall under your deductible. Most MA plans charge monthly premiums, and this amount differs depending on the insurance company and plan you choose. You are also responsible for paying a deductible, just like Part A. Note: This article does not discuss Medigap policies. Medigap policies are a different type of premium assistance and are considered part of Part B rather than Part A.

    Part D: Medicare Prescription Drug Coverage

    What Is Prescription Drug Coverage?

    Medicare Part D is the third way to receive Medicare coverage. Part D was introduced as a government strategy to lower healthcare costs overall. Hopefully, by making drugs more affordable for people on Medicare, they wouldn’t have to see a doctor about their ailments or injuries. That way, doctors would be able to spend less time seeing patients and more time doing research and bettering their practices.

    In Part D, you are covered for medications and drugs your doctor prescribes as long as they are included in your plan.

    What Does It Cover?

    Part D covers prescription medications, though it does not cover over-the-counter medications. It also covers other services related to your prescription drugs, such as a mail-order delivery program for new prescriptions. Part D does not include mental health services or dental care: though many plans will offer a discount on certain dental services, it does include vision care.

    What It Costs:

    Each MA plan has a different set of rules and is not bound by any specific rules. As with MA, Part D has no enrollment fee or premium. You have no deductible to pay either: Part D will pay for your medications as long as they are covered by the plan you choose. If a charge for your medication falls under your plan, you must pay the cost of that medication, just like with other chronic illnesses, such as diabetes.

    Medicare is an essential part of most senior citizens’ lives. Without it, many would not be able to afford the medical care they need and deserve. Medicare is one of the most important things you will ever pay for during your life, but once you qualify, you may find that it’s not as complicated as you thought.


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