Medicare can seem overwhelming at first glance — with its alphabet soup of Parts A, B, C, and D, plus something called Medigap. But once you understand what each part covers and how they fit together, you can make informed decisions about your health coverage as you approach age 65.
In this post, we break it all down in clear, simple terms.
What Is Medicare?
Medicare is a federal health insurance program for people 65 and older, and for some younger individuals with disabilities.
It’s divided into several parts, each covering different services — and you can choose how you receive your benefits based on your needs and budget.
Medicare Part A: Hospital Insurance
Part A covers inpatient hospital care, skilled nursing facility stays, hospice care, and some home health care.
✅ What’s covered?
- Inpatient hospital care
- Skilled nursing after a hospital stay
- Hospice and palliative care
- Some home health services
✅ What it costs:
Most people pay $0 premium if they worked and paid Medicare taxes for at least 10 years.
There’s a deductible ($1,632 per benefit period in 2025) and daily coinsurance for extended stays.
Medicare Part B: Medical Insurance
Part B covers outpatient care — like doctor visits, preventive services, lab tests, medical equipment, and some home health care.
✅ What’s covered?
- Doctor and specialist visits
- Outpatient surgeries
- Preventive care (like mammograms and flu shots)
- Durable medical equipment (like walkers and wheelchairs)
✅ What it costs:
The standard premium is $178.80/month in 2025 (higher for high-income earners), plus an annual deductible of $240. After the deductible, you pay 20% of the Medicare-approved amount for most services.
Medicare Part C: Medicare Advantage
Part C, also known as Medicare Advantage, is an all-in-one alternative to Original Medicare (Parts A and B) offered by private insurance companies approved by Medicare.
✅ What’s included?
- All benefits of Part A and B
- Usually includes Part D (prescription drug coverage)
- May include extras like dental, vision, hearing, fitness memberships, and transportation
✅ What it costs:
Premiums vary by plan — some even have $0 premiums — but you still pay your Part B premium.
Out-of-pocket costs depend on your plan’s structure and network.
Medicare Part D: Prescription Drug Coverage
Part D helps cover the cost of prescription drugs. Plans are offered by private insurers and work alongside Original Medicare (or sometimes as part of a Medicare Advantage plan).
✅ What’s covered?
- Wide variety of prescription medications
- Each plan has a formulary (list of covered drugs), so check that your medications are included
✅ What it costs:
Premiums vary, averaging $35–$45/month, with additional copays and deductibles.
What About Medigap?
Medigap, also known as Medicare Supplement Insurance, helps cover the “gaps” in Original Medicare (Parts A and B), such as deductibles, copayments, and coinsurance.
It does not work with Medicare Advantage plans.
✅ Why consider Medigap?
- Reduces your out-of-pocket costs
- Provides more predictable healthcare expenses
- Lets you see any provider that accepts Medicare
✅ What it costs:
Premiums vary by plan type, location, and age.
Popular plans include Plan G and Plan N, which offer comprehensive coverage.
Which Option Is Right for You?
Choosing between Original Medicare with Medigap and Part D, or a Medicare Advantage plan, depends on your healthcare needs, budget, and lifestyle.
If you want flexibility and lower out-of-pocket costs, Original Medicare with Medigap might be best.
If you prefer all-in-one simplicity and don’t mind a provider network, Medicare Advantage could work for you.
Get Personalized Guidance
Making sense of Medicare doesn’t have to be stressful. At MedicareFor65.com, our licensed agents are here to guide you every step of the way.
✅ Press the phone icon on our website to get a call within 60 seconds, or
✅ Schedule an appointment now at: https://medicarefor65.com/calendar
We’ll help you review your options and make sure you’re fully covered.
