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Medicare and You: The Basics About Medicare

What are the different parts of Medicare?

Medicare Part A (Hospital Insurance) helps cover:

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care

Medicare Part B (Medical Insurance) helps cover:

  • Services from doctors and other health care providers
  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Many preventive services

Medicare Part C (Medicare Advantage):

  • Includes all benefits and services covered under Part A and Part B
  • Usually includes Medicare prescription drug coverage (Part D) as part of the plan
  • Run by Medicare-approved private insurance companies that follow rules set by Medicare
  • May include extra benefits and services for an extra cost

Medicare Part D (Medicare prescription drug coverage):

  • Helps cover the cost of prescription drugs
  • Run by Medicare-approved private insurance companies that follow rules set by Medicare
  • May help lower your prescription drug costs and help protect against higher costs in the future

How can I get my Medicare coverage?

When you first enroll in Medicare, you’ll have Original Medicare, unless you make another choice. Here are the different ways you can get your Medicare coverage:

1. You can stay in Original Medicare. If you want prescription drug coverage, you’ll need to join a Medicare Prescription Drug Plan (Part D). If you don’t join a Medicare drug plan when you’re first eligible and you don’t have other creditable prescription drug coverage, you may pay a late enrollment penalty if you choose to join later. See pages 90–92 for more information about the late enrollment penalty.

2. You can choose to join a Medicare Advantage Plan (like an HMO or PPO) if one’s available in your area. The Medicare Advantage Plan may include Medicare prescription drug coverage. In most cases, you must take the drug coverage that comes with the Medicare health plan if it’s offered. In some types of plans that don’t offer drug coverage, you may be able to join a Medicare Prescription Drug Plan.

Before making any decisions, learn as much as you can about the types of coverage available to you. The next 2 pages include information to help you with your coverage choices. If you need more information, you can:

1. Visit the Medicare Plan Finder at Medicare.gov/find-a-plan.

2. Get personalized counseling about choosing coverage. See page 121 for the phone number of your State Health Insurance Assistance Program (SHIP).

3. Call 800-MEDICARE (800-633-4227) and say “Agent.” TTY users should call (877) 486-2048.

 

Click the link below for the complete Medicare and You PDF document