Medicare: Parts A, B, C, and D
Understanding Medicare: Parts A, B, C, and D
Medicare is made up of four different parts. Each part covers specific services, and understanding how they work together can help you make confident healthcare decisions.
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Medicare Part A – Hospital Coverage
Medicare Part A helps cover care when you are formally admitted to a hospital or need certain types of facility-based care.
Part A generally covers:
• Inpatient hospital stays
• Skilled nursing facility care (after a qualifying hospital stay)
• Hospice care
• Limited home health services
Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working. However, Part A does include deductibles and cost-sharing depending on the length and type of care received.
Part A does not cover:
• Long-term custodial nursing home care
• Routine dental, vision, or hearing services
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Medicare Part B – Medical Coverage
Medicare Part B covers most outpatient and preventive medical services.
Part B generally covers:
• Doctor visits and specialist care
• Outpatient services and emergency room visits
• Preventive services and screenings
• Lab work, imaging, and diagnostic tests
• Durable medical equipment (such as walkers or oxygen)
• Certain medications administered in a clinical setting
Part B typically requires a monthly premium, an annual deductible, and cost-sharing for services.
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Medicare Part C – Medicare Advantage Plans
Medicare Part C, also known as Medicare Advantage, is an alternative way to receive your Medicare benefits through a private insurance company approved by Medicare.
Medicare Advantage plans must cover at least the same Medicare-covered services as Part A and Part B and often include additional benefits, such as:
• Prescription drug coverage (Part D included in many plans)
• Dental, vision, and hearing benefits
• Over-the-counter (OTC) allowances
• Fitness and wellness programs
• Transportation and meal benefits (plan-specific)
Groceries and food benefits may be available for certain Special Needs Plans (such as C-SNP or D-SNP), based on eligibility and plan design.
Medicare Advantage plans operate with provider networks and set copayments. These plans also include an annual maximum out-of-pocket limit for covered medical services.
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Medicare Part D – Prescription Drug Coverage
Medicare Part D helps cover prescription medications filled at a pharmacy or through mail order.
Each Part D plan has:
• A list of covered medications (formulary)
• Tiered pricing for different drugs
• Pharmacy network rules
Even individuals who take few medications may benefit from enrolling in Part D to avoid potential late enrollment penalties.
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How Medicare Coverage Is Typically Structured
Most people receive Medicare in one of the following ways:
Original Medicare (Part A + Part B)
Often paired with:
• A stand-alone Part D prescription drug plan
• A Medicare Supplement (Medigap) policy to help with out-of-pocket costs
Medicare Advantage (Part C)
A bundled plan that typically includes:
• Part A and Part B coverage
• Prescription drug coverage
• Additional benefits not included in Original Medicare
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Choosing the Right Medicare Coverage
The right Medicare setup depends on several factors, including:
• Your healthcare needs and budget
• Your preferred doctors and pharmacies
• Prescription medications you take
• Eligibility for Medicaid, Extra Help (LIS), or Special Needs Plans (C-SNP)
Medicare choices can change from year to year, and what works for one person may not be the best option for another.
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Important Information & Disclosure
Anthony’s Healthcare provides Medicare education and guidance only. We are not affiliated with or endorsed by the U.S. government, the federal Medicare program, or any state Medicaid agency.
Medicare consists of multiple parts (Part A, Part B, Part C, and Part D), each with its own rules, costs, and coverage limitations. Medicare Advantage (Part C), Prescription Drug Plans (Part D), Medicare Supplement (Medigap) policies, and Special Needs Plans (D-SNP, C-SNP) are offered by private insurance companies that are approved and regulated by Medicare.
Coverage, premiums, deductibles, copayments, coinsurance, provider networks, formularies, service areas, and extra benefits may vary by plan, carrier, county, and contract year and are subject to change. Extra benefits such as dental, vision, hearing, fitness programs, transportation, over-the-counter allowances, food or grocery benefits, meals, and in-home services are not guaranteed and may have limitations or eligibility requirements.
Information provided is for educational purposes only and does not guarantee eligibility, coverage, or enrollment.