Medicare Plans Explained

Medicare has several parts — and understanding how they work together is the first step to making a confident decision. Here's what you need to know.

Part A

Medicare Part A

Hospital Insurance

Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services.

What it covers:

  • Inpatient hospital care (after deductible)
  • Skilled nursing facility care (up to 100 days)
  • Hospice care for terminal illness
  • Some home health services

Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. However, there are deductibles and coinsurance costs.

Have questions about Medicare Part A?

Matt can walk you through how this fits into your overall Medicare picture — at no cost.

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Part B

Medicare Part B

Medical Insurance

Part B covers doctor visits, outpatient care, preventive services, and medically necessary services.

What it covers:

  • Doctor and specialist visits
  • Outpatient hospital services
  • Preventive screenings and vaccines
  • Durable medical equipment (wheelchairs, walkers)
  • Mental health services
  • Ambulance services

Part B has a standard monthly premium (set annually by the government) plus an annual deductible. After the deductible, Medicare typically pays 80% and you pay 20% — with no out-of-pocket maximum under Original Medicare alone.

Have questions about Medicare Part B?

Matt can walk you through how this fits into your overall Medicare picture — at no cost.

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Part C

Medicare Part C

Medicare Advantage

Medicare Advantage plans are offered by private insurance companies approved by Medicare. They bundle Part A, Part B, and usually Part D into one plan.

What it covers:

  • Combines Parts A, B, and usually D
  • Often includes extra benefits (dental, vision, hearing)
  • Uses provider networks (HMO or PPO)
  • May have lower monthly premiums than supplements
  • Annual out-of-pocket maximum protects you from catastrophic costs
  • Plans vary significantly by county and carrier

Medicare Advantage plans are regional — they use networks of doctors and hospitals. If you travel frequently or split time between states, this is an important consideration.

Have questions about Medicare Part C?

Matt can walk you through how this fits into your overall Medicare picture — at no cost.

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Part D

Medicare Part D

Prescription Drug Coverage

Part D plans help cover the cost of prescription drugs. They are offered by private insurance companies approved by Medicare.

What it covers:

  • Covers brand-name and generic prescription drugs
  • Each plan has a formulary (list of covered drugs)
  • Costs vary by plan, drug tier, and pharmacy
  • Available as a standalone plan or bundled in Medicare Advantage
  • Late enrollment penalty applies if you go without creditable coverage

Not all Part D plans cover the same drugs at the same cost. Running a comparison based on your specific medications and preferred pharmacy can save you hundreds of dollars per year.

Have questions about Medicare Part D?

Matt can walk you through how this fits into your overall Medicare picture — at no cost.

Ask Matt
Supplement

Medicare Supplement

Medicare Supplement (Medigap)

Medicare Supplement plans (also called Medigap) work alongside Original Medicare to help cover out-of-pocket costs like deductibles, copays, and coinsurance.

What it covers:

  • Helps pay costs Original Medicare doesn't cover
  • Works with any doctor or hospital that accepts Medicare
  • No provider networks — use any Medicare-accepting provider nationwide
  • Standardized plans (Plan G, Plan N, etc.) — same benefits regardless of carrier
  • Predictable costs make budgeting easier
  • Does not include drug coverage — requires a separate Part D plan

Medicare Supplement plans are ideal for people who want predictable costs and the freedom to see any Medicare-accepting provider. They typically have higher monthly premiums but lower out-of-pocket costs when you need care.

Have questions about Supplement plans?

Matt can walk you through how this fits into your overall Medicare picture — at no cost.

Ask Matt

Medicare Advantage vs. Medicare Supplement

One of the most common decisions in Medicare — here's a side-by-side look at how the two approaches compare.

Feature
Medicare Advantage
Medicare Supplement
Works with any Medicare doctor
Includes prescription drug coverage
Extra benefits (dental, vision, hearing)
Predictable out-of-pocket costs
Out-of-pocket maximum protection
Lower monthly premiums
Nationwide provider access
No referrals needed (PPO)

Neither option is universally better — the right choice depends on your health, budget, and lifestyle. Matt can help you compare both based on your specific situation.

Not Sure Which Plan Is Right for You?

That's exactly what we're here for. Schedule a no-cost consultation and Matt will walk you through your options based on your doctors, prescriptions, and budget.