Original Medicare
Understanding the Original Medicare Program
The Original Medicare Program includes four main parts. At any given time, you’ll typically be using either Part A, Part B, and Part D or Part C. Here’s a breakdown of each part to help you understand your options:
Medicare Part A
Part A covers inpatient hospital stays, skilled nursing facility care, hospice services, and some home health care.
Most people don’t pay a monthly premium for Part A if they’ve worked and paid Medicare taxes for at least 40 quarters (about 10 years).
If you use Part A benefits, there is a one-time deductible that must be met before coverage begins. Once met, you’re generally covered for the first 60 days, after which copayments and coinsurance may apply.
Medicare Part B
Part B provides coverage for outpatient care—such as doctor visits, lab work, surgeries, specialist care, and preventive services.
There is a monthly premium for Part B. If you are receiving Social Security benefits, this premium is typically deducted from your check. If not, you’ll need to pay the premium quarterly.
Part B also has a yearly deductible. After meeting it, Medicare usually pays 80% of covered services, and you’re responsible for the remaining 20%.
Medicare Part C
Medicare Part C, also known as Medicare Advantage (MA or MAPD), is an alternative to Original Medicare.
These plans are offered by private insurance companies and often include additional benefits like prescription drug coverage, dental, vision, and more.
Most Medicare Advantage plans are either HMOs or PPOs and have specific provider networks. If you enroll in a Medicare Advantage plan, it becomes your primary insurance instead of Original Medicare—though you still need to pay your Part B premium.
Medicare Part D
Part D helps cover the cost of prescription drugs. You can get this coverage either as a standalone Prescription Drug Plan (PDP) or as part of a Medicare Advantage plan that includes drug coverage.
Part D plans are offered by private insurers that work with Medicare. It’s important to have drug coverage when you join Medicare, or you could face a late enrollment penalty.
Need help choosing?
To explore whether Original Medicare with a Supplement and Drug Plan or a Medicare Advantage plan is right for you, simply click one of the buttons below. You can also Fill out the form below to speak with us directly—we’re here to help!
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