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What Is Medicare?

If you ever find yourself asking the question “what is Medicare?”, then you’ve come to the right place for answers. Medicare is the government health insurance program for people aged 65 and older. Some younger people also qualify for Medicare, such as those who have been receiving disability benefits for 24 months or suffer from certain medical conditions like End-Stage Renal Disease (ESRD) and Lou Gehrig’s Disease (ALS). 

Medicare covers a variety of health care costs, and people who are enrolled in Medicare have a number of options when it comes to personalizing their health coverage. Read on to learn about the Medicare benefits associated with each part of Medicare.


What Is Medicare? The Parts of Medicare

It is also helpful to understand that Medicare is divided into four parts: Part A, Part B, Part C (Medicare Advantage), and Part D (prescription drug coverage).


Medicare Part A

Just to offer a general overview, Medicare Part A is one half of Original Medicare. Part A hospital insurance is the facet of Medicare that helps pay for inpatient hospital stays, along with skilled nursing facility care, hospice, and home health care. Medicare Part A covers expenses related to your hospital stays (semi-private rooms, meals, nursing, etc.), along with inpatient mental health care.

You can enroll in Medicare Part A through Social Security, though many people will be automatically enrolled once they become eligible for Medicare. You won’t have to pay any premium for Medicare Part A if you or your spouse worked and paid Medicare taxes for the required amount of time (10 years).


Medicare Part B

Medicare Part B medical insurance is the other half of Original Medicare. Medicare Part B covers outpatient medical costs, such as doctor’s visits, ambulance services, preventive services, medically necessary equipment, outpatient mental health care, and more. 

You can also enroll in Part B through Social Security. Most people will have to pay a monthly premium for their Part B coverage. The standard Part B premium in 2021 is $148.50.


Medicare Part C (Medicare Advantage)

When people talk about Medicare Part C, they’re actually referring to Medicare Advantage. Medicare Advantage plans are an alternative way to get you Medicare coverage. These plans do not replace your Part A and Part B coverage, but rather they become primary to your Original Medicare coverage. Medicare Advantage policies often include extra benefits, such as drug coverage, hearing coverage, vision coverage, dental coverage, and more.

Unlike with Original Medicare, you have to enroll in Medicare Advantage with a private health insurance company. These “all-in-one” plans replace your Original Medicare coverage. Everyone has the option to enroll in a Medicare Advantage plan when they first become eligible for Medicare.


Medicare Part D (Prescription Drug Coverage)

By now you’re probably wondering what Medicare Part D is. Medicare Part D is the part of Medicare that provides prescription drug coverage. Part D drug plans help to cover the costs of prescription drugs, along with select shots and vaccines.  

As is the case with Medicare Advantage, you must enroll in a Medicare Part D prescription drug plan through a private insurance company. Alternatively, some Medicare Advantage plans come with prescription drug coverage.


Medicare Supplements

You may also have the option to buy Medicare Supplement Insurance, or Medigap plans. These policies work by supplementing your Original Medicare coverage. Medigap plans help pay for things that Original Medicare doesn’t cover, such as deductibles, copayments, coinsurance, and more

Medigap plans can be purchased from private insurance companies by people who have Medicare Parts A and B. However, if you are enrolled in a Medicare Advantage Plan, you cannot be enrolled in a Medigap policy at the same time. Additionally, Medigap plans do not offer coverage for your prescription drugs, so you will need to enroll in a stand-alone Part D drug plan if you want help paying for your medications.


Need help choosing a Medicare policy?

If you would like to explore your health plan options, schedule a consultation with a team member here at Medicare Plans Direct. We can answer your Medicare-related questions and help you to set up the coverage that’s right for you.

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