Part A – Inpatient Hospital

Part A generally covers inpatient care in a hospital or skilled nursing facility, as well as some home health and hospice services.

• Inpatient hospital stays
• Skilled nursing facility care (limited)
• Some home health care
• Hospice care

Deductible (from chart): $1,716 per benefit period.

Part B – Outpatient Medical

Part B helps cover medically necessary services and supplies needed to diagnose or treat a condition, plus many preventive services.

• Doctor and specialist visits
• Lab work and diagnostic tests
• Outpatient hospital services
• Emergency room visits
• Ambulance services (when medically necessary)

Premium (from chart): $206.50 / month
Deductible (from chart): $288 per year.

Medigap Supplement Plans

Medigap plans (such as G, N, and K) are offered by private insurers to help pay some of the costs Original Medicare doesn’t cover, like copays, coinsurance, and deductibles.

• You must have Part A & Part B to enroll in a Medigap policy.
• Plans are standardized by letter (G, N, K, etc.) but prices vary by company.
• Only one person per Medigap policy; spouses need separate policies.
• Medigap policies generally don’t include Part D drug coverage.

Part D – Prescription Drug Plans

Part D plans help cover prescription drugs and are offered by private companies approved by Medicare.

• Each plan has its own list of covered drugs (formulary).
• Costs can include deductibles, copays, and coverage phases.
• Late enrollment penalty of about 1% per month if you go without creditable coverage when first eligible.

You can customize this area with your four questions: Name, Dose, Frequency, Pharmacy.

Part C – How Medicare Advantage Bundles Coverage

The Part C section of the chart shows how Medicare Advantage plans combine:

• Part A – inpatient hospital coverage
• Part B – outpatient medical coverage
• Often Part D – prescription drug coverage (optional in some plans)

Instead of using Original Medicare plus a separate Part D and possibly a Medigap policy, a Medicare Advantage plan wraps most of this into a single private plan.

Medicare Advantage – Advantages

The blue “Advantages” area highlights some common features of many Medicare Advantage plans (specifics vary by plan):

• All coverage in one plan card
• Ability to choose doctors within a network (HMO, PPO, etc.)
• ER & urgent care coverage while traveling
• Low to no additional monthly plan premiums (you still pay Part B)
• Predictable copays instead of 20% coinsurance
• Annual maximum out-of-pocket limit for covered services
• Extra benefits such as dental, vision, hearing, gym programs, and wellness visits