Parts of Medicare

Parts of Medicare: What are the differences?

Before choosing a Medicare plan, you should be aware of the differences between each plan.

Part A

Medicare Part A is hospital insurance, covering inpatient care in a hospital, skilled nursing facility care, nursing home care, hospice care, and home health care.

Part B

Medicare Part B is medical insurance, covering medically necessary services and preventive screening services. This includes clinical research, ambulance services, durable medical equipment, mental health care, and limited outpatient prescription drugs.

Medicare Advantage

Medicare Advantage plans are offered by private companies approved by Medicare to manage your coverage for Part A and Part B. These are commonly in the form of HMOs, PPOs, or PFFS. Additionally, plans may offer dental, hearing, vision, or prescription drug coverage.

Part D

Prescription Drug Plans each choose the prescription drugs they will cover. All plans cover at least two drugs in each of the most commonly prescribed categories. Part D plans cover most antidepressants, antipsychotics, anticonvulsants, antiretrovirals (AIDS treatment), immunosuppressants, and anticancer prescription drugs.

Each plan has its list of covered drugs, called a formulary. The drugs are grouped into tiers that determine the copayment required. Generic, preferred drugs have the lowest copayment, followed by name-brand, non-preferred, and specialty prescription drugs.

Medicare Supplement (Medigap)

Medicare Supplement plans, also called Medigap plans, exist to cover the costs or a portion of the costs from Medicare Part A and Part B. These include the deductibles, copayments, coinsurance, and blood needed for medical procedures. Six of the ten available plans offer foreign travel emergency health care coverage. Each plan differs in its cost and coverage.

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