Discover the Full Coverage of Your Medicare Insurance

There are four parts of Medicare: Part A, Part B, Part C, and Part D.

A picture of the four different types of medicare coverage.

Part A (Hospital Insurance)

Inpatient care in a hospital.
Skilled nursing facility care.
Nursing home care (inpatient care in a skilled nursing facility that's not custodial or long-term care).
Hospice care.
Home health care.

Most people don't pay a monthly premium for Part A, sometimes called premium-free Part A. However, If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $506. If you paid Medicare taxes for 30–39 quarters, the standard Part A premium is $278.

Part A has a $1,632 deductible for each benefit period. This means if you are admitted into the hospital again for a different issue or the same issue after a 60-day break, you will have to meet the deductible again. There is no limitation to benefit periods and no out-of-pocket maximum with Part A.

Part B (Medical Insurance) Helps Cover

Services from doctors and other health care providers
Outpatient care
Home health care
Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)
Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)

The premium for part B in 2025 is $180.00. However, if your income is over $106,000 for single or $212,000 for married, you may have to pay more. Click here to see your rate.

Part B has a $240 deductible. After your deductible is met, you typically pay 20% of the Medicare-Approved Amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment (DME).

Medicare allows doctors and equipment suppliers to charge an excess charge. A doctor who doesn't accept assignments may charge you up to 15 percent more than the Medicare-approved amount.

This overage is known as a Part B excess charge. This is not covered by Medicare and you would be responsible for the bill. Part B, like Part A, does not have an out-of-pocket maximum.

You are required to have a Part B (Medical Insurance) when eligible for Medicare or you are penalized for the remainder of the time you are on Medicare. See how the late enrollment penalty works.

Part C (Medicare Advantage Plans) Help Cover

Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” or “MAPD Plans” are offered by Medicare-approved private companies that must follow rules set by Medicare.

Most Medicare Advantage Plans include drug coverage (Part D) in addition to services like dental, vision, hearing, fitness memberships, transportation, and other programs, Not Available on Original Medicare. In most cases, you’ll need to use health care providers who participate in the plan’s network.

These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, unlike Original Medicare. Some plans offer nonemergency coverage out of network, but typically at a higher cost Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans to make many plans have a $0 premium. However, depending on where you live or what plan you choose, you may have a low premium. See more about Medicare Advantage plans.

Part D (Drug Coverage (PDP)) Helps Cover

You join a Medicare drug plan in addition to Original Medicare, or you get it by joining a Medicare Advantage Plan with drug coverage. Plans that offer Medicare drug coverage are run by private insurance companies that follow rules set by Medicare.

The costs, design, and formularies vary greatly between the many Part D drug plans. Contact Metro Valley Insurance to help you find the best plan for your drug needs. If you provide us with a list of your drugs, dosages, and quantity, we can compare all the drug plans available in your area to find the most economic one for you!

You are required to have a Part D (Drug Plan) when eligible for Medicare or you are penalized for the remainder of the time you are on Medicare. See how the late enrollment penalty works.

Major changes to part D coverage in 2025

The Inflation Reduction Act, a new drug law, will make several changes to Medicare Part D plans in 2025, including:

Out-of-pocket costs

Beneficiaries' out-of-pocket (OOP) spending will be capped at $2,000, and there will be no cost sharing above that threshold.

Coverage gap

The coverage gap phase, also known as the "donut hole", will be eliminated. In the donut hole, beneficiaries pay up to 25% out of pocket for covered medications.

Benefit design

Part D coverage will consist of three phases: deductible, initial coverage, and catastrophic.

Prescription drug payment plan

Plans will offer the option to pay prescription drug costs in monthly installments.

Medicare Supplemental Insurance (Medigap)

Extra insurance you can buy from a private company that helps pay your share of costs in Original Medicare. Policies are standardized and in most states named by letters, like Plan G or Plan K. The benefits in each lettered plan are the same, no matter which insurance company sells it. However, the price and customer service can vary.

What’s the Difference Between Medicare and Medicaid?

Medicare is federal health insurance for anyone age 65 and older and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that provides health coverage for some people with limited income and resources.

Medicaid offers benefits, like nursing home care, personal care services, and assistance paying for Medicare premiums and other costs.

If you qualify, you can have both Medicare and Medicaid. Having both Medicare and Medicaid may entitle you to a Dual Medicare Advantage plan that offers better and more unique benefits.

Learn More About Dual