Medicare

Part B - Medical Coverage

Part B is the medical side of Medicare. Where Part A covers hospital stays, Part B covers the care you get outside the hospital.

• Doctor visits, outpatient care, and preventive services
• Lab work and diagnostic tests
• Durable medical equipment like wheelchairs and walkers
• A monthly premium and an annual deductible, with a share of costs after that
• A late enrollment penalty that can stay on your premium for life if you delay without other qualifying coverage

Medicare Advantage (Part C):

Medicare Advantage is an all-in-one alternative to Original Medicare, offered through private insurers approved by Medicare. A Medicare Advantage plan will bundle your coverage and usually add more.

• Combines Part A and Part B in a single plan
• Usually includes prescription drug coverage (MAPD)
• Often adds extras like dental, vision, hearing, and fitness benefits
• Frequently a low or zero plan premium, though you still pay your Part B premium
• Caps what you pay out of pocket each year, which Original Medicare does not

The tradeoff is structure. Advantage plans use provider networks, may require referrals or prior approval, and can change their benefits and drug lists every year. The right plan depends on your doctors and your prescriptions.

Part D - Prescription Drug Coverage (PDP):

Part D covers prescription drugs through private insurers approved by Medicare. A standalone Part D plan, often called a PDP, is what you add to Original Medicare when you want drug coverage.

• Commonly paired with a Medigap, or Medicare Supplement, plan
• Fills the prescription gap Medicare Supplements leaves, since Medicare Supplements do not cover drugs
• Covers a specific list of drugs that varies by plan, so the right one depends on the medications you take
• Carries a late penalty if you go too long without other creditable drug coverage

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Medicare Supplement (Medigap)

A Medicare Supplement plan, also called Medigap, is private coverage that fills the gaps in Original Medicare. It picks up the deductibles, coinsurance, and copays Original Medicare leaves to you.

• Standardized by letter, so the same plan offers the same core benefits no matter who sells it
• Any doctor or hospital nationwide that accepts Medicare, with no networks or referrals
• Predictable costs that stay steady month to month
• Usually paired with a standalone Part D plan, since Medigap does not cover drugs

One timing point matters most. When you first enroll in Part B at 65, you have a six-month window to buy almost any Medigap plan regardless of your health. Miss it, and an insurer can usually review your health history and charge more or turn you down.