Original Medicare, which includes Parts A and B, is the primary healthcare coverage option for about two-thirds of Medicare beneficiaries
Medicare Part A, often referred to as hospital insurance, helps cover inpatient care received in a hospital or skilled nursing facility (SNF). It also provides coverage for hospice care and certain home healthcare services when they are linked to a qualifying hospital stay.
Individuals who have paid Medicare taxes for at least 40 quarters (equivalent to 10 years) qualify for premium-free Part A. Those who haven’t met this requirement can still enroll but must pay a monthly premium, which is set at $518 for 2025.
Additional out-of-pocket expenses for Part A include a $1,600 deductible per benefit period, along with coinsurance costs if a hospital stay extends beyond 60 days in a single benefit period.
Medicare Part B, known as medical insurance, covers outpatient healthcare services that a Medicare-approved provider determines to be medically necessary. This typically includes visits to a doctor’s office for diagnosing or treating health conditions.
Additionally, Part B provides coverage for preventive screenings, lab tests, durable medical equipment (DME), and mental health services.
In 2025, the standard monthly premium for Medicare Part B is $185. However, individuals with higher incomes may be subject to an increased premium. Other expenses include an annual deductible of $226, along with a coinsurance requirement—typically 20% of the Medicare-approved amount for covered services.
Medicare Advantage plans are offered by private insurance companies and are required to provide the same benefits as Original Medicare.
However, many plans go beyond the standard coverage and include additional benefits such as:
Prescription Drug Coverage
Routine Vision Care
Routine Dental Care
Hearing Aids
Fitness Programs or Gym Memberships
Coverage options and costs can vary based on the plan and provider.
If you’re considering enrolling in a Medicare Advantage plan, it’s important to compare different options carefully.
While some plans feature a $0 monthly premium, it’s essential to review other potential costs such as deductibles, copayments, and coinsurance to understand the total expense of coverage.
Medicare Part D is prescription drug coverage offered through private insurance companies approved by Medicare. It helps cover the cost of medications, including both brand-name and generic drugs, and is available to anyone enrolled in Medicare Part A and/or Part B.
Part D plans vary by provider, with different formularies, pharmacy networks, and out-of-pocket costs. While enrollment is optional, delaying it without other credible drug coverage may result in a late enrollment penalty.
Choosing the right Part D plan ensures you have affordable access to the medications you need to stay healthy.
Medicare Supplement Insurance, commonly known as Medigap, helps cover certain out-of-pocket expenses associated with Original Medicare.
These plans are sold by private insurance companies but follow standardized benefits. This means that a Medigap Plan A policy provides the same coverage regardless of the insurer, and the same applies to Plans B, C, G, and others. However, pricing varies depending on the provider
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