Medicare Coverage Explained

Are you a Veteran? Discover Medicare plans made in honor of our country's heroes, with Exclusive Discounts and Perks Learn More →

The Basics

Medicare is a federal health insurance program for people aged 65 and older, and for some younger individuals with certain disabilities or conditions.

While it offers essential protection for your health and finances, Medicare isn’t a one-size-fits-all plan. It’s made up of different parts that work together to cover specific healthcare needs.

Coverage is broken down into 5 segments. For a better understanding, these aren't always ordered alphabetically, as seen below:

Part A
This Covers Hospital Stays

Part B
This Covers Medical Costs

Medigap
This helps to lower Copayments and Deductibles for parts A and B

Part D
This covers Prescription Drugs

Part C (Medicare Advantage)
This private cover Combines A, B and Sometimes D with a Private Provider

Let's compare these 5 Coverage Parts.

Part A - Hospital Insurance

What it covers:

• Inpatient hospital stays
• Skilled nursing facility care
• Hospice care
• Limited home health care

What it costs:
Most people don’t pay a premium for Part A if they’ve worked and paid Medicare taxes for at least 10 years.

However, you’re still responsible for deductibles and coinsurance when you use hospital services. These are broken down as follows:

Medicare Part A Costs 2026 - Hospital Stays

$838 PER DAY LIFETIME RESERVE DAYS CO-PAYMENT 

When your hospital stay exceeds 90 days time during the benefits period, a feature referred to as “Lifetime Reserve Days” takes effect.

ALL COSTS

After your Lifetime Reserve Days run out. If you don’t have the full 60 reserve days however, then you will start paying all costs before the 151st day.

Medicare Part A Costs 2025 - Skilled Nursing Facility Stays

Part B - Medical Insurance

What it covers:

• Doctor visits
• Outpatient care (e.g. lab, imaging)
• Preventive services (screens, vaccinations)
• Durable medical equipment (walkers, oxygen, etc.)
• Some home health services not covered under Part A

What it costs:

Part B comes with a monthly premium (set each year by Medicare) and a small annual deductible.

After meeting the deductible, Medicare typically pays 80% of approved services — you pay the remaining 20%.

Medicare Part B Costs 2026 - Medical Insurance

Medicare Supplement (Medigap)

What it covers:

Medigap is aimed at covering additional costs which might not be covered in Parts A & B. For example, Deductibles and Copayments

What it costs:

These plans vary depending on what coverage you need. While upfront costs may be a little higher, deductibles are lower as a result.

Part D - Prescription Drugs

What it covers:

Also known as Prescription Drug Coverage, Medicare Part D helps cover the cost of prescription drugs, including many recommended shots or vaccines.

What it costs:

Plans that offer Medicare Drug coverage are run by private insurance companies that follow rules set by Medicare.

Part C - Medicare Advantage

What it covers:

Also known as Medicare Advantage, Part C plans replace Original Medicare (Parts A + B) and often include Part D (drug coverage) plus extras such as dental, vision, hearing, wellness programs, etc.

What it costs:

Plans may have lower out-of-pocket costs than Original Medicare, and in many cases you’ll have to use doctors that are in the plan’s network. Most plans offer extra benefits that Original Medicare doesn’t cover, like vision, hearing, dental, and more.

Unsure Which Coverage is Right For You?

The right Medicare plan can protect your health and your wallet.

Let’s take the confusion out of coverage, and find a plan that fits you perfectly.

Get in touch today, and gain clarity over your Medicare Coverage Options.