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Medicare For Beginners
Medicare can feel confusing at first—lots of letters, rules, and options. This guide breaks everything down in plain English with diagrams to help you understand how the pieces fit together.
What is Medicare?
Sounds like an obvious question? It's that insurance that covers your medical expenses when your retired. [][][]
Medicare is a federal health insurance program for:
- People 65 and older
- People under 65 with certain disabilities
- People with End-Stage Renal Disease (ESRD) or ALS
It helps cover hospital care, doctor visits, medications, and other medical needs. But unlike regular insurance, Medicare isn’t just one single plan—it's a system made of different parts.
The Four Parts of Medicare
Part A – Hospital Insurance
What it covers:
- Inpatient hospital stays
- Skilled nursing facilities
- Hospice care
- Some home health care
Cost basics:
Most people get Part A Free if they or their spouse worked and paid Medicare taxes for 10+ years.
You pay a deductible per benefit period when hospitalized.
Part B – Medical Insurance
What it covers:
- Doctor visits
- Outpatient care
- Preventive services (flu shots, screenings, etc.)
- Ambulance services
- Durable medical equipment
Cost basics:
- Monthly premium (varies by income)
- Annual deductible
After deductible: usually 80% covered by Medicare, 20% you pay
Think of Part B as:
🩺 The insurance you use most often day-to-day.
Part C – Medicare Advantage (an alternative)
Medicare Advantage plans bundle:
```
Part C = Part A + Part B + (usually) Part D
```
These are all-in-one plans from private insurance companies with Medicare’s approval.
They often include:
* Dental
* Vision
* Hearing
* Gym benefits
* Nurse hotlines
BUT:
You typically use the plan’s network, similar to an HMO/PPO.
Think of Part C as:
📦 A packaged version of Medicare with extra benefits.
Part D – Prescription Drug Coverage
Part D plans are offered by private insurers but regulated by Medicare.
What it covers:
* Medications you pick up at a pharmacy
* Some vaccines
Cost basics:
* Monthly premium
* Usually a deductible
* Copays/coinsurance depending on the drug
Think of Part D as:
💊 Drug coverage similar to what you'd have in an employer plan.
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Medicare Team is not affiliated with Medicare, the U.S. government, or any state or federal agency. This is an advertisement. Callers will be connected with a licensed insurance agent who may offer Medicare Advantage plans (HMO, PPO, PFFS), Medicare Supplement, and stand-alone prescription drug plans (PDP). We do not offer every plan available in your area. Currently, we represent 6 organizations which offer 2,352 products. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment is subject to the plan’s contract renewal.