Breaking Down the Parts of Medicare
Breaking Down the Parts of Medicare
A simple breakdown of A, B, C, and D—without the alphabet soup.
“Clarity is the beginning of confidence.” — Robin Sharma
Navigating Medicare can feel like learning a foreign language. With terms like Part A, Part B, Part C, and Part D thrown around, it’s easy to feel lost before you even get started. But once you understand what each part covers, choosing the right path becomes much clearer—and far less intimidating.
Let’s break it down in plain English.
Part A: Hospital Insurance
Think of Part A as your Medicare hospital coverage. It helps pay for:
Inpatient hospital stays
Skilled nursing facility care (after a qualifying hospital stay)
Hospice care
Limited home health services
Cost:
Most people pay $0 per month for Part A if they (or their spouse) worked at least 10 years. In 2025, the hospital deductible is $1,632 per benefit period.
When you need it:
If you’re ever admitted to the hospital or a skilled nursing facility, Part A is your safety net.
Part B: Medical Insurance
Part B covers the day-to-day health care most of us use more frequently, including:
Doctor visits
Preventive services (like screenings and vaccines)
Lab work
Durable medical equipment
Outpatient services
Cost:
The standard monthly premium in 2025 is $174.70, but higher-income earners may pay more due to IRMAA (Income-Related Monthly Adjustment Amount).
There’s also a deductible of $240 per year and typically 20% coinsurance for covered services.
Part C: Medicare Advantage (MAPD)
Part C, also known as Medicare Advantage, is offered by private insurance companies approved by Medicare. These plans bundle Parts A and B—and often Part D—into one plan.
Bonus Benefits Often Included:
Prescription drug coverage
Dental, vision, and hearing care
Gym memberships and wellness programs
Over-the-counter benefits
Transportation assistance
Cost:
Some plans have $0 monthly premiums, though you still pay your Part B premium. You may also have copays and deductibles depending on the plan.
Watch Out:
You’ll typically have to use a network of doctors, and referrals may be required for specialists.
Part D: Prescription Drug Coverage
Part D is optional prescription drug coverage available through private insurers. It helps pay for:
Generic and brand-name medications
Vaccines not covered by Part B
Medications filled at pharmacies or via mail order
Cost:
Monthly premiums vary by plan and income level. Be sure to choose a plan that covers the medications you take regularly.
Penalty Alert:
If you don’t enroll in Part D when you’re first eligible and don’t have other credible drug coverage, you may face a lifetime late enrollment penalty.
Putting It All Together
PartCoversProvided ByNotesAHospital insuranceFederal MedicareFree if you worked 10 yearsBMedical insuranceFederal MedicareMonthly premium, 20% coinsuranceCMedicare AdvantagePrivate insurersBundled A, B, often D, plus extrasDPrescription drug coveragePrivate insurersOptional, penalty if you delay enrollment
Which Path Should You Take?
Original Medicare (Parts A & B): Great if you want provider freedom and plan to add Medigap for cost protection.
Medicare Advantage (Part C): A good choice if you want an all-in-one plan with extra perks—but make sure your doctors are in-network.
Part D: Crucial for anyone needing prescription coverage.
How KEyO Insurance Services Helps
At KEyO, we simplify the Medicare maze. Our advisors walk you through every option, help you compare plans side-by-side, and ensure your decisions match your lifestyle and needs—with Trusted Care. Tailored for You.
Final Thought:
Understanding the ABCDs of Medicare is the first step in making confident decisions about your health and your future. Let us help you move from overwhelmed to in control.
