Navigating Medicare can be challenging, especially with the terminology often confusing even seasoned beneficiaries. Understanding the difference between Medicare “Parts” and “Plans” can help you avoid misinterpretations when shopping for new coverage and making plan changes.

Medicare Parts

Medicare is divided into several parts, each covering different types of healthcare services:

1. Medicare Part A (Hospital Insurance): This part covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Most people don’t pay a premium for Part A because they or their spouse paid Medicare taxes while working.
2. Medicare Part B (Medical Insurance): Part B covers outpatient care, doctor visits, preventive services, and some home health care. Beneficiaries typically pay a monthly premium for Part B.

[Part A + Part B together are often referred to as “Original Medicare”]

1. Medicare Part C, AKA Medicare Advantage Plans: Offered by private companies, Medicare Advantage plans replace Original Medicare by providing all Part A and Part B benefits, and often include additional benefits such as dental, vision, and prescription drug coverage. These plans are an alternative to Original Medicare and usually require beneficiaries to use a network of providers.
2. Medicare Part D, AKA Prescription Drug Plans: Part D helps cover the cost of prescription drugs. These plans are offered by private insurance companies and are available to anyone with Medicare.

As you can see, Parts C & D also represent different types of Medicare Plans.

Medicare Plans

In contrast to the parts of Medicare, Medicare plans refer to the various health insurance options available to beneficiaries within the Medicare program. These include:

1. Medicare Advantage Plans (Part C): As mentioned, these plans are an alternative to Original Medicare and are offered by private insurers. They often bundle Part A, Part B, and sometimes Part D benefits, providing comprehensive coverage.
2. Medicare Supplement Insurance Plans (Medigap): Medigap plans are sold by private companies and help cover some of the out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. There are different standardized Medigap plans (labeled A through N), each offering a different set of benefits.
3. Standalone Part D Plans: These are separate prescription drug plans available to those with Original Medicare. They help cover the cost of medications not included in Parts A and B.

Key Differences

• Parts of Medicare refer to the different components of the federal Medicare program, each designed to cover specific types of healthcare services (hospital, medical, and prescription drugs).
• Medicare Plans refer to the insurance options available to beneficiaries to manage and supplement their Medicare coverage, which can include Medicare Advantage plans, Medigap policies, and standalone Part D plans.

By distinguishing between these terms, beneficiaries can better understand their options and choose the coverage that best meets their healthcare needs. Whether opting for Original Medicare with supplemental plans or a comprehensive Medicare Advantage plan, understanding these terms is crucial for making informed decisions.

For help with Medicare plans – or any questions you may have about Medicare – contact AMAC’s Medicare Advisory Service at 1-855-611-4856 or request a quote below.