What is Medicare?

Learn the basics of Medicare and what each part covers.

How Medicare Works

Original Medicare is the federal health insurance program primarily for people age 65 and older, as well as some younger individuals with certain disabilities or conditions. It’s made up of two parts (Part A and B) and gives you the freedom to visit any doctor or hospital in the U.S. that accepts Medicare. It is designed to help cover many routine and unexpected medical costs.

What is Part A of Medicare?

Part A, otherwise known as your hospital insurance, helps pay for hospital stays, skilled nursing facilities, hospice care, and some home health care. If you have worked over 10 years, this often has a $0 premium.

What is Part B of Medicare?

Part B covers doctor visits, preventive care, outpatient services, and certain medical equipment. Many refer to Part B as your medical insurance.

Why It Matters for Your Health

Choosing Original Medicare means you can see providers across the country without being limited to a network. It also offers a foundation of coverage that you can enhance with additional plans, like Medicare Supplement Insurance (Medigap) or Medicare Part D for prescription drugs.

What Is Part C (Medicare Advantage)?

Medicare Advantage, or Part C, is an alternative to Original Medicare offered by private insurance companies approved by Medicare. These plans combine Parts A and B, and often include additional benefits like vision, dental, hearing, and prescription drug coverage—all in one plan. Some Medicare Advantage plans go beyond this and offer benefits like transportation, flexible spending cards, respite care services and more.

What Is Part D (Prescription Drug Coverage)?

Part D helps cover the cost of prescription medications and is offered by private insurers approved by Medicare. You can add a Part D plan to Original Medicare or some Medicare Advantage plans to help lower your out-of-pocket costs for prescriptions.

What Original Medicare Covers

• Part A: Hospital care, skilled nursing, hospice care, limited home health care.
• Part B: Doctor visits, outpatient care, preventive services, medical equipment.
• Services and supplies considered medically necessary by a healthcare provider.

What Original Medicare Doesn’t Cover

• Prescription drugs (unless you have Part D).
• Routine dental, vision, and hearing services.
• Long-term custodial care.
• Most care outside the United States.

What Is a Special Needs Plan?

A Special Needs Plan (SNP) is a type of Medicare Advantage plan designed to provide targeted benefits and services to specific groups of people. These plans are available for individuals who have certain chronic conditions, live in a nursing home, or qualify for both Medicare and Medicaid (dual-eligible). SNPs tailor their provider networks, drug formularies, and care coordination to meet the unique healthcare needs of their members.

• Focused Coverage: Benefits and services designed for specific health needs.
• Coordinated Care: Specialized provider networks and care teams for better health outcomes.
• Tailored Drug Coverage: Formularies that include medications commonly used by the plan’s target group.