Medicare offers four Parts (A, B, C, and D). Original Medicare consists of parts A (hospital coverage) and B (medical insurance), with the optional purchase of Part D (prescription-drug coverage) and Medigap policy (a supplemental insurance policy for original Medicare). Part C is considered an alternate type of policy (Medicare Advantage Plan), and may not be purchased in combination with original Medicare or a Medigap policy.
Part A generally covers things such as care received while you are an inpatient in a hospital, skilled nursing facility, or nursing home. It may also include care received through hospice services, and may cover some home-health services as well.
Medicare Part A is traditionally considered hospital insurance, while Medicare Part B is generally considered medical insurance. Medicare Parts A and B together are considered “traditional” or “original” Medicare and you will be automatically enrolled in both when you receive Medicare (at the time your reach 65 years of age, or during your 25th month on Social Security Disability Insurance). Please note that in some circumstances, you can decline Part B; however, generally speaking, if you accept enrollment in Part A, you must also accept Part B.
Part B: Medical Insurance
Part B generally covers medical expenses, such as durable medical equipment, lab services, testing, and other health services that are considered medically necessary for treating a disease or health condition. These services may apply to the diagnostic and treatment phase of a health condition. Additionally, Part B covers several types of preventive health services.
If in doubt whether Medicare Part A or B covers a particular provider, service, facility, or other medical need, please discuss the situation with the prescribing physician and consult with Medicare regarding coverage.
Optional Choices with Original Medicare
Medicare Part D is an optional enrollment plan. Part D is utilized by almost everyone on Medicare since it is the prescription-drug option. Please note that individuals who participate in Part C – the Medicare Advantage Plan – may only purchase Part D if their plan does not include prescription drug coverage.
A Medigap policy is just a supplement to the original Medicare benefits plan (A and B) and may include increased coverage of things such as co-pays and co-insurance that Medicare doesn’t cover. If a person has a Medigap policy, bills will be paid first through the original Medicare plan, and then go through the supplemental Medigap policy for additional coverage. Also, a Medigap policy cannot be used toward co-pays or co-insurance with a Medicare Advantage Plan.
For More Information
Visitors to MSAA’s online My Health Insurance Guide are invited to browse throughout the different sections for more information on the different parts of Medicare as well as other insurance options, or to view our Healthcare Insurance Glossary, online video and webinars, or our new publications.
To learn more about original Medicare or to enroll in this program, please visit Medicare.gov.