The four parts of Medicare
Part A: hospital insurance
Part A helps pay for care when you're admitted to a hospital. It also helps with care in a skilled nursing facility after a qualifying hospital stay, hospice care, and some home health care.
Most people don't pay a monthly premium for Part A, because they or their spouse paid Medicare taxes while working long enough. You still pay a deductible and other costs when you use it.
Part B: medical insurance
Part B helps pay for doctor visits, outpatient care, lab tests, preventive services like screenings and many vaccines, and medical equipment like walkers and wheelchairs.
Part B has a monthly premium. The amount is set each year. People with higher incomes pay more. Most people pay it out of their Social Security check.
Part C: Medicare Advantage
Medicare Advantage plans are offered by private insurance companies approved by Medicare. They provide your Part A and Part B coverage, and most include drug coverage. Learn about Medicare Advantage.
Part D: prescription drug coverage
Part D helps pay for prescription drugs. You can get it through a stand-alone plan or through a Medicare Advantage plan. Learn about Part D.
Two ways to get your coverage
When you're first eligible, you'll choose how to get your Medicare.
| Topic | Original Medicare | Medicare Advantage |
|---|---|---|
| What it is | Part A and Part B, run by the federal government. | A plan from a private company that provides your Part A and Part B coverage. |
| Doctors | Any doctor or hospital in the U.S. that accepts Medicare. | Usually a network of doctors and hospitals. |
| Drug coverage | Add a separate Part D plan. | Included in most plans. |
| Help with costs | No yearly limit on what you pay. Many people add a Medicare Supplement plan. | A yearly limit on what you pay for covered Part A and Part B services. |
| Extra benefits | Generally not included. | Some plans may include dental, vision, or hearing benefits. These vary by plan and county. |
Neither choice is right for everyone. It depends on your doctors, your prescriptions, how you travel, and how you prefer to pay for care.
What Medicare doesn't cover
Original Medicare doesn't cover everything. Some of the most common gaps are:
- Most dental care, like cleanings, fillings, and dentures
- Eye exams for glasses, and the glasses themselves
- Hearing aids and exams to fit them
- Long-term custodial care, such as help with bathing and dressing in a nursing home or at home
- Most care outside the U.S.
Some Medicare Advantage plans may offer some dental, vision, or hearing benefits. What's covered varies by plan. Long-term custodial care generally isn't covered by Medicare Advantage or Supplement plans either.
Medicaid and dual eligibility
Medicaid is a separate program, run by the state with federal help, for people with limited income and resources. Some people qualify for both Medicare and Medicaid. This is called being dual eligible.
If you're dual eligible, Medicaid may help pay your Medicare premiums and other costs. You may also be able to join a Special Needs Plan built for people with both.
Some people who don't qualify for full Medicaid can still get help paying their Part B premium through a Medicare Savings Program. In Georgia, you can learn about and apply for these programs through Georgia Gateway or your local Division of Family and Children Services (DFCS) office.
Where to get official information
- Medicare.gov or 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048)
- Social Security at 1-800-772-1213, to sign up for Medicare
- GeorgiaCares, Georgia's State Health Insurance Assistance Program (SHIP), which offers free, unbiased Medicare counseling at 1-866-552-4464 (option 4)