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Understanding Medicare

Understanding how Medicare works can be overwhelming at first. We’re here to help. Learn how the different parts of Medicare work, when you’re eligible to enroll, and tips to select a plan that may work for you.

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What are the four parts of Medicare?

The four parts of Medicare are Part A (hospital coverage), Part B (medical coverage), Part C (hospital and medical coverage combined, sometimes with drug coverage) and Part D (prescription drug coverage).

There are two ways to get Medicare coverage: by enrolling in Original Medicare (Part A and Part B) or by enrolling in a Medicare Advantage Plan (Part C). You may want to add Part D for prescription drug coverage.

Original Medicare (offered through the federal government)

Part A – Hospital coverage

Part A covers inpatient hospital care, skilled nursing facility care, hospice, lab tests, surgery, and home healthcare.

Part B – Medical coverage

Part B covers provider visits, healthcare provider services, outpatient care, medical equipment, home healthcare, and some preventive services.

If you need additional coverage, you have choices:

Part C – Medicare Advantage (offered by private insurers)

These are the Medicare plans offered by Bright Health and other private insurance companies. Medicare Advantage plans combine the benefits of Parts A and B, and most also come with prescription drug coverage plus extra benefits and features not offered through Original Medicare. Medicare Advantage plans take the place of Original Medicare. You must still be enrolled in Original Medicare (Parts A and B) to enroll in a Medicare Advantage plan, but you’ll receive your benefits through the Medicare Advantage plan instead. 

Part D – Prescription drug coverage (offered by private insurers)

Part D plans cover prescription medications. Original Medicare (Parts A and B) does not include coverage for most prescription drugs. If you take prescriptions, you'll want to enroll in a Part D plan that covers your medications, or enroll in a Medicare Advantage plan that includes coverage for prescription drugs. Coverage varies from plan to plan, so be sure to check the plan’s formulary (drug list) before enrolling to be sure your medications are included. Also check your medication’s tier in the formulary, as drugs are grouped into tiers with different levels of coverage.

Medicare Supplement Plans (state-regulated and offered by private insurers)

Sometimes called “Medigap,” these plans help cover some of the out-of-pocket costs not covered by Original Medicare, like deductibles, copays and coinsurance. Medicare Supplement Plans are purchased from private insurers to be used with Original Medicare (Parts A and B).

What doesn’t Medicare cover?

Original Medicare coverage does not include prescription drug coverage, long-term care, dental, eye exams related to prescriptions for glasses, dentures, cosmetic surgery, acupuncture, hearing aids/exams, or routine foot care.

Medicare Advantage plans cover the same services Original Medicare covers, plus additional coverage and benefits.

Next: Eligibility

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