Medicare Plans A & B
Understanding Medicare Parts A, B, and D
Medicare can feel confusing at first — but don’t worry, we’re here to make it simple. Here’s a quick breakdown of the three core parts of Original Medicare:
Medicare Part A – Hospital Insurance
Part A helps cover your care when you’re admitted to a hospital. It also includes skilled nursing facility care, hospice, and some home health services. Most people don’t pay a premium for Part A if they worked and paid Medicare taxes long enough.
Medicare Part B – Medical Insurance
Part B covers doctor visits, outpatient care, lab work, preventative services, and some home health care. There is a monthly premium for Part B, and it’s important to sign up on time to avoid penalties.
Once you sign up for Medicare, you can join a health or drug plan at certain times. To join a Medicare Advantage Plan (Part C), you need both Part A and Part B. To join a Medicare drug plan (Part D), you only need Part A or Part B.
What is a Medicare Advantage Plan?
A Medicare Advantage Plan (also known as Part C) is a Medicare-approved health plan offered by a private insurance company. When you join one of these plans, it becomes your primary Medicare coverage — meaning you’ll get all your Part A (hospital) and Part B (medical) benefits through the plan instead of Original Medicare.
Most Medicare Advantage Plans also include prescription drug coverage, and many offer extra benefits like dental, vision, hearing, and wellness programs.
Medicare Part C – Medicare Advantage
Medicare Part C, also known as Medicare Advantage, is an all-in-one alternative to Original Medicare (Parts A & B). These plans are offered by private insurance companies and often include:
• Everything covered by Parts A and B
• Prescription drug coverage (Part D)
• Extra benefits like dental, vision, hearing, and fitness programs
• A yearly out-of-pocket maximum for added financial protection
There are different types of Medicare Advantage Plans available, including:
HMO (Health Maintenance Organization)
PPO (Preferred Provider Organization)
Private Fee-for-Service Plans
Special Needs Plans (SNPs)
Medicare Medical Savings Account (MSA) Plans
With Medicare Advantage, you still have the same rights and protections as with Original Medicare — but with added benefits and often lower out-of-pocket costs. Many people choose Medicare Advantage for the added convenience and potential cost savings. We’ll help you compare options and see if it’s the right fit for your needs.
Not sure which plan type fits your needs? That’s what we’re here for. Let our team at Surface Financial Group help you find a plan that works for your lifestyle, health, and budget.
Medicare Part D
Medicare Part D – Prescription Drug Coverage
Part D helps pay for your prescription medications. It’s offered by private insurance companies approved by Medicare, and you can add it to your Original Medicare coverage. Plans and costs vary, so we’ll help you find one that fits your needs and prescriptions.
Need help figuring out what’s best for you?
Our team at Surface Financial Group is here to walk you through every step — at no cost to you. We’ll help you choose the right coverage with confidence and peace of mind.
Supplemental Plans
- Work with Original Medicare: Medigap plans supplement Original Medicare, meaning Medicare pays its share first, and then your Medigap policy covers its portion of the costs, such as deductibles, copayments, and coinsurance.
- Standardized plans: Medigap plans are standardized by the federal government, identified by letters (A, B, C, D, F, G, K, L, M, and N). Each plan with the same letter offers identical basic benefits, regardless of the insurance company.
- No network restrictions: You can typically see any doctor or hospital that accepts Medicare, as Medigap plans don’t have network limitations.
- Guaranteed renewability: As long as you pay your premiums, your Medigap policy is guaranteed to be renewed each year, even if your health changes.
- Part A coinsurance and hospital costs: Medigap plans can help cover the costs associated with inpatient hospital stays, including coinsurance and additional days after Medicare benefits are used up.
- Part B coinsurance or copayment: They help cover the 20% coinsurance amount for most Part B services.
- Blood (first 3 pints): Many plans cover the cost of the first 3 pints of blood.
- Part A hospice care coinsurance or copayment: Medigap can help cover hospice care costs.
- Other potential benefits (depending on the specific plan): These may include skilled nursing facility care coinsurance, Part A deductible, Part B deductible, Part B excess charges, and foreign travel emergency care.
- Prescription drugs: Medigap plans sold after 2005 do not include prescription drug coverage. You can enroll in a separate Medicare Part D plan for this.
- Long-term care: Such as care in a nursing home.
- Vision or dental services:
- Hearing aids or eyeglasses:
- Private-duty nursing:
- Open Enrollment Period: The best time to buy a Medigap policy is during your Medigap Open Enrollment Period, which is a 6-month window starting the month you turn 65 and first have Medicare Part A and Part B. During this time, you have guaranteed issue rights, meaning insurance companies cannot deny you coverage or charge you more due to pre-existing conditions.
- Costs: Medigap plan premiums can vary based on factors like age, location, and plan type. You’ll pay this premium in addition to your Medicare Part B premium.
- Find available plans: Use tools like Medicare.gov’s plan comparison tool or contact your State Health Insurance Assistance Program (SHIP).
- Compare plans and prices: Choose a plan and compare its benefits and costs offered by different insurance companies.
- Contact the company: Get an official quote and fill out the application.