What is the difference between Medicare Parts vs. Medicare Plans. Let’s break it down.
Medicare Parts
There are 4 parts of Medicare: A, B, C, & D. Medicare A & B are Original Medicare. They will cover most of your basic medical needs. Medicare Part A will cover your inpatient care. Medicare Part B will cover your outpatient care.
There is usually no monthly premium for Medicare Part A, but Medicare part B does have a monthly premium which is based on your income. Additionally, there are deductibles to meet and copays or coinsurances for services rendered.
You will likely be automatically enrolled when you turn 65. If not, you will need to contact social security.
Medicare Part C is also known as Medicare Advantage. It is an alternative to Original Medicare. If you elect to enroll, you must do so during the annual enrollment period or a special enrollment period if you qualify. Medicare Part C plans must offer at least the same benefits as Original Medicare, but they often offer additional benefits such as:
- Dental
- Vision
- Hearing
- Prescription Drugs
These benefits are not offered by Medicare Part A & Part B. Advantage plans will also impose an OOP max. However, you will give up access to the extremely broad Original Medicare network which can be quite restricting.
The last “part” of Medicare is Medicare Part D. Medicare Part is your prescription drug coverage. Original Medicare does not offer prescription drug coverage. Again, you will not be automatically enrolled so you must do so during the AEP or a SEP if you qualify.
You will pay a small monthly premium and be subject to a deductible based on the plan that you pay. Prescriptions may have set copays or coinsurance.
Medicare Plans
If something is referred to as a plan, it is a Medicare Supplement aka Medigap. There are ten Medicare Supplement Plans to choose from. If it helps you to remember, there are 10 letters in S-U-P-P-L-E-M-E-N-T and ten Medicare Supplement Plans.
Medicare Supplement plans work with Original Medicare. They do not offer additional benefits, but they will help to cover the financial gaps or Original Medicare such as deductibles, copays and coinsurance. If they do not cover the entirety of your OOP costs, they will also impose an OOP max.
The plans offer varying levels of coverage. You can view all of the plans on Medicare.gov. You can enroll in a Medicare Supplement plan year round, but it’s in your best interest to do you during your IEP. This is the six months after you turn 65 and enroll in Medicare Part B. During this time you will not be subject to medical underwriting.
Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.
