The parts of Medicare, explained

Part A: Hospital insurance

Part A covers inpatient care. Most people pay $0 in premiums for Part A if they or their spouse worked and paid Medicare taxes for at least 10 years (40 quarters). If you paid fewer than 40 quarters, you pay a monthly premium.

• Inpatient hospital stays: Semi-private room, meals, general nursing, and hospital services.
• Skilled nursing facility care: Up to 100 days per benefit period following a qualifying 3-day hospital stay.
• Hospice care: Pain management and support for terminal illness, typically in your home.
• Some home health care: Part-time skilled nursing or therapy ordered by your doctor.

Part B: Medical insurance

Part B covers outpatient care. The standard premium in 2025 is $185.00 per month, though higher earners pay more through an IRMAA surcharge. Part B has a $257 annual deductible, then covers 80% of approved costs. You pay the remaining 20%.

• Doctor visits: Primary care and specialist visits, including telehealth.
• Preventive services: Annual wellness visits, flu shots, mammograms, and colonoscopies.
• Outpatient procedures: Surgeries, lab tests, and imaging done without an overnight stay.
• Durable medical equipment: Wheelchairs, walkers, CPAP machines, and blood sugar monitors.

Part C: Medicare Advantage

Medicare Advantage is an all-in-one alternative to Original Medicare offered by private insurers approved by CMS. These plans must cover everything Parts A and B cover, and most include Part D drug coverage. Many also add dental, vision, and hearing benefits not covered by Original Medicare.

Part D: Prescription drug coverage

Part D covers prescription medications. These plans are sold by private insurers and vary widely in which drugs they cover (the formulary), what tiers those drugs fall into, and what you pay. If you have Original Medicare without a drug plan, enroll in Part D during your Initial Enrollment Period or you may face a permanent late penalty.

Medigap: Supplemental coverage

Medigap (also called Medicare Supplement) is private insurance that fills the cost-sharing gaps left by Original Medicare, including the Part B 20% coinsurance and hospital deductibles. Medigap works alongside Original Medicare, not instead of it. You cannot have both a Medigap plan and a Medicare Advantage plan at the same time.

Common questions