Whether you’re approaching 65 or helping a loved one navigate their options, Medicare can feel overwhelming at first. The good news? Once you understand what each part covers — and how they work together — it all starts to make sense. Here’s a plain-language breakdown of the four parts of Medicare.

In this article

  1. Part A — Hospital insurance
  2. Part B — Medical insurance
  3. Part C — Medicare Advantage
  4. Part D — Prescription drug coverage
  5. Which parts do you need?

Part A  Hospital insurance

Part A covers inpatient care — the services you receive when you’re admitted to a hospital, skilled nursing facility, or hospice. It also covers some home health care.

What it covers:

  • Inpatient hospital stays
  • Skilled nursing facility care (following a qualifying hospital stay)
  • Hospice care
  • Limited home health services
Most people pay $0 in premiums for Part A if they (or their spouse) worked and paid Medicare taxes for at least 10 years.
Part B Medical insurance

Part B covers outpatient services — the doctor visits, lab work, and preventive care you receive outside of a hospital stay.

What it covers:

  • Doctor visits and specialist appointments
  • Outpatient procedures and surgeries
  • Preventive screenings and vaccines
  • Lab tests, X-rays, and medical equipment
  • Mental health services
Part B has a monthly premium (set each year by the government) and an annual deductible. After that, Medicare generally pays 80% of approved costs — which is why many people pair Part B with a supplement plan.

Part C Medicare Advantage

Part C, also called Medicare Advantage, is an alternative to Original Medicare (Parts A and B). These plans are offered by private insurance companies approved by Medicare and must cover everything that Parts A and B cover — but often include extras.

Common additions include:

  • Prescription drug coverage (Part D)
  • Dental, vision, and hearing benefits
  • Fitness programs and wellness perks
Medicare Advantage plans typically have lower monthly premiums than a Medigap plan, but may have narrower provider networks or prior authorization requirements. It’s important to compare your options carefully.
Part D Prescription drug coverage

Part D helps cover the cost of prescription medications. It’s offered through private insurers and is separate from your medical coverage — unless you have a Medicare Advantage plan that bundles it in.

Key things to know:

  • Each plan has a formulary (list of covered drugs)
  • Costs vary depending on the plan and your medications
  • There’s a late enrollment penalty if you go without creditable drug coverage for 63+ days after becoming eligible
Even if you don’t take many medications right now, enrolling in a Part D plan when you’re first eligible can protect you from late penalties down the road.

Which parts do you actually need?

The right combination depends on your health, your budget, and whether you’re still covered by an employer plan. Most people will need at least Parts A and B — and then choose between a Medicare Supplement (Medigap) plan + Part D, or a bundled Medicare Advantage plan.

There’s no one-size-fits-all answer, which is exactly why it helps to talk through your options with an independent insurance agent who knows the local plans available in your area.

Ready to figure out which parts are right for you?

The team at Powanda Insurance Agency is here to help you compare your options at no cost to you. We work with multiple carriers so you always get unbiased guidance.

If you’d like help reviewing your Medicare options with provider access in mind, click here to schedule a personal Medicare one-on-one, no-cost strategy session.

Contact Powanda Insurance Agency →

We don’t offer every plan available in your area. Any information provided is limited to those plans we do offer. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Program to get information on all of your options.

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