Medicare Parts A, B, C, & D (2025 Details)
Medicare Parts A, B, C, and D cover hospital insurance, medical insurance, and prescription drugs for Medicare recipients. Medicare Part C combines all parts of Medicare into one plan and premium. Monthly premiums vary, but signing up late for Medicare could result in a 1% penalty per month on Medicare Part D.
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Michelle Robbins
Licensed Insurance Agent
Michelle Robbins has been a licensed insurance agent for over 13 years. Her career began in the real estate industry, supporting local realtors with Title Insurance. After several years, Michelle shifted to real estate home warranty insurance, where she managed a territory of over 100 miles of real estate professionals. Later, Agent Robbins obtained more licensing and experience serving families a...
Licensed Insurance Agent
UPDATED: Sep 11, 2025
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We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes should be easy. This doesn’t influence our content. Our opinions are our own.
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.
UPDATED: Sep 11, 2025
It’s all about you. We want to help you make the right legal decisions.
We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes should be easy. This doesn’t influence our content. Our opinions are our own.
On This Page
Medicare Parts A, B, C, and D provide healthcare to millions of Americans over 65. Each Medicare part covers different aspects of medical care, from hospital stays to prescription drugs.
Medicare Parts A and B are the most common parts and provide hospital and medical insurance, respectively. If you aren’t sure what parts you want on your Medicare plan, our expert guide to Medicare parts is for you.
- Original Medicare Plans include Part A and Part B
- Medicare Part C is also known as Medicare Advantage
- Medicare Part D covers prescription drugs
We cover what each different part of Medicare covers in detail, as well as exclusions and costs. To speak with a licensed insurance agent about your Medicare needs, call (855) 634-0435 today.
Medicare Parts A, B, C, and D Explained
What are Medicare Parts A and B and C and D? Medicare Parts A and B make up Original Medicare plans. These plans will provide you with hospital and medical insurance. Medicare Advantage plans, also known as Medicare Part C, provide Part A and Part B, as well as additional benefits.
Is Medicare Part C better than Parts A and B? Check out our article on Medicare Advantage vs. Original Medicare to see which better fits your needs. For example, Medicare Advantage Plans often also include Medicare Part D, which helps cover the cost of prescription drugs. Keep reading for a full breakdown of each of the parts of Medicare that make up both the Original and Advantage plans.
Medicare Part A
Medicare Part A is a crucial coverage component of all Medicare plans. If you need hospital care or other advanced medical care, it will help cover your costs. Part A also helps cover the cost of nursing home stays as well as hospice care for recipients.
It is important to note that there are some limitations to Medicare Part A’s hospital insurance. Not every aspect of care will be covered. For instance, Medicare Part A only covers short-term rehab at skilled nursing facilities, and you must have had a three-day hospital stay beforehand to qualify.
Medicare Part A: Hospital Insurance| Coverage | Details | Eligibility |
|---|---|---|
| Inpatient Hospital Care | Room, meals, nursing, meds | Age 65+ or disability |
| Skilled Nursing Facility | Short-term rehab only | 3-day prior hospital stay |
| Hospice Care | End-of-life care | Terminal illness confirmed |
| Home Health Services | Part-time skilled care at home | Homebound, doctor-directed |
| Blood Transfusion | Covers after 3 pints | Medically necessary |
| Benefit Period | Resets after 60 days | Limits per period apply |
Hospice care will be covered if a terminal illness is confirmed. It’s important to note that with all the insurance coverages of Part A, the benefits period resets after 60 days. This means that even if you used Part A’s services, if it has been longer than 60 days, it will reset, and you will have to pay a deductible again if you need to use Medicare Part A again.
Medicare Part B
Medicare Part B is an important coverage that helps pay for the majority of healthcare needs. It complements Medicare Part A by covering healthcare outside of the hospital, such as regular doctor appointments and lab tests. If you’re considering which parts of Medicare to buy, make sure your plan includes Medicare Part B.
As with Medicare Part A, policyholders must meet certain criteria to have Medicare Part B help cover some healthcare aspects, which is typical of any health insurance coverage. For example, you must have a doctor’s prescription to get medical equipment like hospital beds or oxygen covered.
Medicare Part B: Medical Insurance| Coverage | Details | Eligibility |
|---|---|---|
| Doctor Visits | Outpatient primary/specialist care | Must be enrolled in Part B |
| Preventive Care | Checkups, vaccines, screenings | Age or risk-based |
| Diagnostic Services | Lab tests, X-rays, imaging | Must be doctor-ordered |
| Medical Equipment | Walkers, oxygen, hospital beds | Doctor’s prescription |
| Mental Health | Therapy and outpatient services | When medically necessary |
| Ambulance Services | Emergency ground transport | No safe alternative available |
Most customers will make the most use out of Medicare Part B, as it helps cover preventive care, doctor visits, and testing. Taking advantage of coverage for screening, vaccinations, and more will also help customers stay on top of their health and catch conditions earlier.
Medicare Part C
Medicare Part C, also known as a Medicare Advantage plan, offers better benefits than an Original Medicare plan. Medicare Part C also combines Part A and Part B, but offers better benefits and often includes Part D, which covers prescription drugs.
The catch is that customers have to sign up to get Medicare Advantage through a private insurance plan, which can be more time-consuming. Medicare Advantage may also not be as widely accepted by healthcare providers as Medicare Original plans, so it’s important to check provider coverage beforehand.
Medicare Part C: Medicare Advantage| Coverage | Details | Eligibility |
|---|---|---|
| Part A & B Combined | Hospital and medical via private plan | Must have Parts A and B |
| Drug Coverage | Often includes prescriptions | Plan must include drug benefit |
| Vision, Dental, Hearing | Routine care and aids | Varies by plan |
| Wellness Programs | Fitness or health memberships | Offered by some plans |
| Cost Limits | Annual out-of-pocket max | Only with Advantage plans |
| Provider Networks | HMO/PPO coordination required | Use in-network (emergencies exempt) |
The benefits of Part C Medicare Advantage plans, however, often outweigh the cons. Medicare Part C includes additional benefits and coverage for more services. Some plans may also include Part D prescription drug coverage. There is also an annual out-of-pocket maximum, so costs are capped.
The disadvantage of Medicare Advantage is that these plans may not be as widely accepted as Original Medicare (Parts A and B). Benefits also vary based on your state laws and the provider you choose. Always compare Medicare plans online before you buy or call (855) 634-0435 to speak with a local agent about your options.
Read More: How to Sign up for Medicare
Medicare Part D
The last Medicare Part is Medicare Part D. It can be added to your Medicare plan, but is not automatically included in Original Medicare or Medicare Advantage plans. To get Medicare Part D, you must have at least Medicare Part A.
What does Medicare Part D cover? The primary purpose of Medicare Part D is to help cover prescription drug costs, which can be a large expense for some individuals. Costs for prescription drugs may not all be covered by Part D.
For example, you may still have a deductible or copay you have to meet on your Medicare plan, so prescription drugs may not be 100% covered by Part D.
Medicare Part D: Prescription Drug Coverage| Coverage | Details | Eligibility |
|---|---|---|
| Prescription Drugs | Covers generic and brand-name meds | Must have Part A and/or B |
| Formulary Tiers | Lower-tier drugs cost less | Drug must be plan-approved |
| Pharmacy Access | Use retail or mail-order in-network | Must use plan network |
| Coverage Phases | Includes deductible, gap, and max phase | Triggered by drug spending |
| Plan Costs | Premium, deductible, and copays | Varies by plan and income |
| Late Penalty | Fee added for late enrollment | No prior creditable drug coverage |
However, Medicare Part D can still be a significant financial help to those on multiple medications, especially those who need very expensive medications. If you have multiple medications, you should consider looking into Medicare plans that include Medicare Part D.
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How Much Medicare Parts A, B, C, and D Costs
Curious about your Medicare Parts A, B, C, and D cost? Standard copays and deductibles are the same on most plans, and generally increase after certain time limits. For example, Medicare Part A copays for skilled nursing costs $0 on days one through 20, and then $209 per day on days 21 through 100.
Medicare Premium, Copay, & Coinsurance Breakdown
| Part | Premium | Copay | Coinsurance |
|---|---|---|---|
| Part A – Hospital Insurance | Usually $0 (premium-free for most) | Skilled Nursing: $0 Days 1–20, $209.50/day Days 21–100 | $0 Days 1–60; $419/day Days 61–90; $838/day after 90 days |
| Part B – Medical Insurance | Monthly premium (varies; penalty if late) | N/A | 20% after deductible |
| Part C – Medicare Advantage | Varies by plan | Varies by plan | Varies by plan |
| Part D – Prescription Drug Coverage | Varies by plan | Varies by plan | Varies by plan; 1% penalty/month if late |
| Medigap | Additional premium (varies by insurer & plan) | Covers Medicare copays | Covers deductibles & coinsurance (depends on plan) |
With Medicare Part A, copays and coinsurance are $0 for a certain set amount of time. After the specific time period has passed, there is a per-day copay or coinsurance charge (Learn More: How much does Medicare cost?). However, premiums will vary by plan if you are getting Medicare through a private insurance company.
Not sure what Medicare Parts you should pay for? The majority of Medicare holders use their Medicare coverage for hospital stays, outpatient care, and doctor visits. Because of this, you should at least consider having Medicare Part A and Part B on your Medicare insurance plan.
Coverage is used less for prescription drugs, so Part D may not be necessary for all customers. However, there is a penalty for buying it late, so if you think you’ll need it, it is best to buy it when you first enroll in Medicare coverage.
Medicare Parts A, B, C, and D Coverage Exclusions
Medicare helps cover a majority of medical costs, but like all healthcare plans, it doesn’t cover every medical bill that a patient receives. There are certain exclusions to coverage that are specific to each Medicare Part’s coverage policies.
It is important to familiarize yourself with exclusions on your Medicare plan so that you don't get taken by surprise by an unexpected bill.
Jeff Root Licensed Insurance Agent
For example, Medicare Part D only covers certain medications that are considered medically necessary. It won’t cover drugs for cosmetic or fertility purposes, for instance. And if you are in the hospital, Medicare Part A won’t cover private duty nursing or a private room, unless a private room is deemed medically necessary.
Medicare Coverage & Exclusions by Part| Medicare Part | What's Covered | Exclusions |
|---|---|---|
| Part A – Hospital Insurance | Inpatient hospital care, skilled nursing facility (short-term), hospice, some home health care | Private duty nursing, long-term custodial care, personal comfort items, private room (unless medically necessary) |
| Part B – Medical Insurance | Doctor visits, outpatient care, preventive services, lab tests, mental health (outpatient), durable medical equipment | Routine dental, routine vision exams/glasses, hearing aids, most prescription drugs, cosmetic surgery |
| Part C – Medicare Advantage | All part A & B services (through private plan), often includes vision, hearing, dental, prescription drugs | Services outside plan's provider network (except emergencies), some non-covered extras depending on plan |
| Part D – Prescription Drug Coverage | Prescription medications (formulary list), vaccines not covered under Part B | Drugs not on formulary, over-the-counter meds, drugs for weight loss/gain, cosmetic or fertility purposes |
If you want to get extra coverage to help with copays and deductibles on what is covered, you may want to look into Medigap supplemental insurance (Medigap). However, the restrictions and exclusions don’t mean that Medicare still doesn’t benefit patients. There are still plenty of pros to each Medicare Part that help balance out the cons.
Choosing Between Medicare Parts A, B, C, and D
Medicare offers seniors and eligible individuals a reliable way to manage healthcare costs, with different parts designed to cover hospital care, medical services, prescription drugs, and bundled benefits. These separate plans exist to give people flexibility in choosing healthcare coverage that matches their needs and budgets (Learn More: How to Finance What Your Health Insurance Won’t Cover).
Medicare Parts A-D Coverage Options: Pros & Cons| Option | Pros | Cons |
|---|---|---|
| Part A | Covers inpatient hospital care, skilled nursing facility, hospice, and some home health services; often premium-free for most | Deductibles and coinsurance apply; limited coverage for long-term care |
| Part B | Covers outpatient care, preventive services, medical supplies, and doctor visits | Monthly premium required; deductible and 20% coinsurance; no dental, vision, or hearing coverage |
| Part C | Combines Parts A & B (and often D) with extra benefits like dental, vision, and wellness programs | May require using network providers; plan benefits and costs vary annually |
| Part D | Helps cover prescription drug costs; wide plan selection | Monthly premiums, deductibles, copays; formulary restrictions and coverage gaps |
The main cons of all Medicare Parts are that there are deductibles and copays to be met. For the most part, though, the benefits outweigh the cons. For example, Medicare Part A is often premium-free for most customers and covers everything from inpatient hospital care to hospice. While coverage can be limited for long-term care, it still helps reduce costs for customers.
Need more assistance with your Medicare options? Enter your ZIP code or call (855) 634-0435 to speak to a licensed representative and learn more about your Medicare options.
Frequently Asked Questions
What are Medicare Parts A, B, C, and D?
Medicare Part A is hospital insurance while Part B is medical insurance. What are Medicare Part C and D? Medicare Part C is known as Medicare Advantage, and includes Medicare Parts A and B with additional benefits. Medicare Part D helps cover prescription drugs.
What is not covered by Medicare Part A or B?
Medicare Part A and Part B do not cover vision or dental care or things like long-term hospitalization or cosmetic treatments.
What is the best Medicare plan that covers everything for seniors?
No Medicare plan will cover everything for seniors, but Medicare Part C and Medigap coverage are among the more comprehensive options. Read our guide on Medicare coverage and eligibility for more information.
Which items will Medicare Part D not cover?
Medicare Part D only covers prescription drugs, so it does not cover hospital stays, medical supplies, or dental or vision care. Part D also doesn’t cover prescription drugs given in a hospital setting, which is covered by Part A.
Why do I need Medicare Part C?
You do not need Medicare Part C, but you may want to get it if you want the additional benefits it offers. Enter your ZIP code to compare Medicare Advantage plans available near you.
Is Medicare Part C free?
No, Medicare Part C is not free, as there are deductibles, copays, and premiums to be paid. Is Medicare Part C based on your income? Yes, having a higher income may mean you have to pay more for Medicare Part C.
Is Medicare Part C deducted from Social Security?
Medicare Part C is not automatically deducted from Social Security, but you can usually request that it be deducted for lower costs. It will likely be deducted from your Social Security if you qualify for Medicaid (Learn More: What is Medicaid?).
Is Medicare Part D really necessary for seniors?
Medicare Part D can be a very useful coverage to help cover the cost of prescription drugs. While it is not mandatory, it can be a great coverage for seniors to have.
Does Medicare Part A cover 100% of hospital bills?
No, Medicare Part A does not cover 100% of hospital bills, as there are still copays and deductibles.
Can I drop my Medicare Advantage plan and go back to Original Medicare?
Yes, you can change back to an original Medicare plan. However, you will have to wait until the enrollment period comes up to do so.
What are the income limits for Medicare?
There are no income limits for Medicare. However, you can only qualify for Medicare Savings Programs (MSPs) if you make under a certain amount.
Do I really need supplemental insurance with Medicare?
Not every customer will need Medicare supplemental insurance. Make sure to consider what coverages you need and your budget. Talking with a licensed insurance agent can help, and we have agents ready to speak with you. Call (855) 634-0435 to get the help you need.
Enter your zip code below to view companies that have cheap insurance rates.
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Michelle Robbins
Licensed Insurance Agent
Michelle Robbins has been a licensed insurance agent for over 13 years. Her career began in the real estate industry, supporting local realtors with Title Insurance. After several years, Michelle shifted to real estate home warranty insurance, where she managed a territory of over 100 miles of real estate professionals. Later, Agent Robbins obtained more licensing and experience serving families a...
Licensed Insurance Agent
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.
