What is Medicare? Parts A-D Explained
- Geri Reynolds
- 1d
- 3 min read
Medicare is the federal health insurance program for millions of Americans — primarily people 65 and older, along with some younger individuals with disabilities or certain medical conditions.
It’s divided into four major parts (A, B, C, and D), each serving a different purpose in helping cover your medical needs — from hospital care to prescription drugs.
"Attention"
Medicare Part A - Hospital Insurance
With Medicare Part A, you don't usually pay a monthly premium if you (or your spouse) paid Medicare taxes while working. This will often be called "premium-free Part A." However, deductibles and coinsurance costs still apply for services. (1)
Medicare Part A helps cover care you receive when you’re in a hospital or facility, including:
Inpatient hospital stays
Skilled nursing facility care
Hospice care
Some home health services
You can get Part A at 65 if you:
Already get benefits from Social Security,
If you're eligible for Social Security, or
You or your spouse were government-employed with Medicare coverage.
You can get Part A under 65 if you:
If you have had Social Security disability benefits for 24 months or
If you have End-Stage Renal Disease and meet requirements.
"Feeling Blah"
Medicare Part B - Medical & Doctors Services
You pay a premium each month for Part B directly to Medicare. Your premium will be automatically deducted from your benefit payment monthly if you get benefits from sources such as these:
Social Security
Railroad Retirement Board
Office of Personnel Management
If you do not have any benefits from these sources, then you are responsible for making your Part B premium payments yourself, which are billed quarterly.
Part B also has an annual deductible that needs to be met before Medicare will cover most services.
Part B pays for services such as:
Doctor visits
Outpatient care
Medical equipment
Preventive services (like annual wellness visits)
"Comprehensive" Medicare Part C
Medicare Advantage
Medicare Advantage (MA) plans are offered by private insurers approved by Medicare. These plans bundle Part A and Part B benefits and often include extra perks like vision, dental, or hearing, but they may have network restrictions or prior authorization rules.
2026 Updates
MA still covers more than half of all Medicare beneficiaries but growth has slowed. (2)
Plans may change benefits or networks from year to year, so reviewing your options each enrollment period is critical.
Medicare Supplement (MedSupp or MediGap)
Original Medicare (Parts A and B) doesn’t cover everything —and many beneficiaries choose Medigap (Supplement) plans to help pay for deductibles, coinsurance, and other gaps in coverage.
Medigap plans are sold by private insurers and standardized by letters (Plan G, N, etc.), each offering different levels of coverage.
"Drug Coverage" Medicare Part D
Part D helps cover the cost of medications through plans sold by private companies.
2026 Updates
The annual out-of-pocket limit on Part D drug costs is $2,100. Once you reach that, your covered medications cost $0 for the rest of the year. (3)
Plans may have premiums, deductibles, and copays, so comparing plans during Annual Enrollment is key.
Medicare now limits how much you pay out-of-pocket for Part D drugs each year, which is a big protection against high pharmacy bills. (3)
Medicare has begun negotiating prices for select high-cost drugs to help reduce prescription costs for beneficiaries. (4)
Enrollment Periods You Should Know
Initial Enrollment Period (IEP)
Starts 3 months before you turn 65, includes your birthday month, and continues 3 months after.
Annual Enrollment Period (AEP)
Every year from October 15 to December 7, you can change or review your Medicare Advantage and Part D plans.
Special Enrollment Periods (SEP)
Certain life events (retirement, moving, loss of employer coverage) may qualify you for a SEP.
Medicare can seem complicated, but breaking it down into its parts — and staying up to date with annual changes — helps you make smarter decisions.
Whether you want Original Medicare with Medigap or a Medicare Advantage plan with extras, review your coverage each year to match your healthcare needs and budget.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area.
Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
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