Medicare Basics
Medicare Parts A, B, C and D Explained in Plain English
What Medicare Part A, Part B, Part C (Medicare Advantage) and Part D each cover, who is eligible, and what Original Medicare leaves out. A plain-English look with the limits spelled out.
Medicare, without the alphabet soup
Medicare is the federal health insurance program for people 65 and older and for some younger people with disabilities. It is split into parts with letters, and the letters are what make it feel confusing. Each part covers a different piece of your care.
Here is an honest, no-pressure look at what each part does, who qualifies, and what Medicare does not cover.
The four parts at a glance
- Part A (hospital insurance): inpatient hospital stays, skilled nursing facility care after a qualifying hospital stay, hospice and some home health care
- Part B (medical insurance): doctor visits, outpatient care, preventive services, lab tests and a lot of medical equipment
- Part C (Medicare Advantage): a plan from a private company that includes Part A and Part B coverage, usually with drug coverage, and often extra benefits
- Part D (prescription drug coverage): a plan from a private company that helps pay for your prescriptions
What Original Medicare is
Original Medicare means Part A and Part B, run directly by the federal government. You can generally see any doctor or hospital in the country that accepts Medicare.
Many people pair Original Medicare with a Medigap (Medicare Supplement) policy and a Part D drug plan. Others choose a Medicare Advantage plan instead. We cover that choice in our Medicare Advantage vs. Medigap guide.
Who is eligible
Eligibility can have exceptions. Social Security decides it, and we're happy to help you sort out what applies to you.
- People 65 or older who are U.S. citizens or lawful permanent residents who have lived in the country for at least five years in a row
- People under 65 who have received Social Security disability benefits for 24 months
- People with ALS (Lou Gehrig's disease) or end-stage renal disease who meet Medicare's rules, which have their own timing
- Part A is premium-free for most people, generally those who (or whose spouse) worked and paid Medicare taxes for about ten years
What Original Medicare does not cover (so there are no surprises)
Premiums, deductibles and copays change from year to year and depend on the plan, where you live and, for some costs, your income. We won't quote a figure before we know your details, and we'll put the costs in front of you in writing before you decide.
- There is no yearly limit on what you pay out of pocket in Original Medicare. Part B generally pays 80% of the approved amount for covered services after the deductible, and you pay 20%
- Most routine dental, vision and hearing care is not covered
- Most outpatient prescription drugs are not covered unless you join a Part D plan
- Long-term custodial care, such as help with bathing and dressing, is generally not covered
- Part B has a monthly premium, and Part A can too if you didn't work enough years. The amounts change every year, so we don't list them here
How we can help
- Explain which parts you have, which you can add, and when
- Walk through Medicare Advantage and Medigap in plain language
- Help you check whether your doctors and prescriptions fit the plans you are considering
- Tell you honestly if a plan isn't the right fit, and point you to free counseling if you want a second opinion
Before you rely on this page
This page is educational. It is not a recommendation of any plan, and it does not promise eligibility, enrollment, pricing or availability.
GetFastRates.com is not connected with or endorsed by the U.S. government or the federal Medicare program. Calling connects you with licensed insurance help. Plan availability, costs, benefits, and enrollment rules can vary by state, carrier, and individual situation.
We do not offer every plan available in your area. We represent a limited number of organizations, which offer a limited number of products in your area. Please contact Medicare.gov, 1-800-MEDICARE (1-800-633-4227), or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options.
Want to talk it through?
Leave your number and a licensed agent will call to talk through where you are and what fits. It's free, and there's no pressure. Please don't put your Medicare or Social Security number in the form.
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Common questions
What is Original Medicare?
Original Medicare is Part A (hospital insurance) and Part B (medical insurance), run by the federal government. Drug coverage (Part D) and Medigap are separate add-ons, and Medicare Advantage is an alternative that bundles these through a private plan.
Do I have to take all four parts?
No. Most people take Part A and Part B, and then choose either a Medicare Advantage plan (Part C) or a Medigap policy plus a Part D drug plan. Some people delay Part B if they have qualifying coverage through work. A licensed agent can help you check before you delay anything.
Is Medicare free?
Part A is premium-free for most people, but Part B has a monthly premium, and Medicare has deductibles and coinsurance. Medicare Advantage and Part D plans have their own costs as well. The amounts change every year.
What is the difference between Medicare and Medicaid?
Medicare is federal health insurance mainly for people 65 and older and some people with disabilities. Medicaid is a joint federal and state program for people with limited income and resources. Some people qualify for both.
Does Medicare cover long-term care?
Medicare covers some short-term skilled nursing care after a qualifying hospital stay, but it generally does not pay for long-term custodial care.
Does it cost anything to talk to an agent?
Talking through your options with us is free and comes with no obligation. Any plan you choose has its own premium, set by the plan and its insurance company.
You don't have to figure this out alone.
Call to talk with a licensed agent who will be honest about what fits and what doesn't.
- Licensed insurance help
- No guaranteed eligibility, pricing, or availability
- Educational starting point
GetFastRates.com is not connected with or endorsed by the U.S. government or the federal Medicare program. Calling connects you with licensed insurance help. Plan availability, costs, benefits, and enrollment rules can vary by state, carrier, and individual situation.