Medicare Brief Guide – not a comprehensive explanation

Medicare in simple terms. Basics to help you understand the Medicare Guide.

Part A – Hospital
Covers inpatient overnight hospital stays. Includes doctor fees, tests, food and a semiprivate room. Will cover some skilled nursing facility convalescence when the criteria is met.

Part B – Medical
Helps to pay for for for out of hospital medical services and products. There are complex rules that govern this benefit, but on a limited basis after a deductible, an approved service or product Medicare will cover 80% and you have to pay the 20% balance.

Part C – Medicare Advantage
Medicare pays a private health plan of your choosing a fixed amount each month to provide  a standard benefit package that allows an enrollee to receive care from a doctor and hospital “network” of providers. Going out of network can incur additional costs.  Medicare Advantage plans include Part D prescription, may have limits, deductible and exclusions.

Part D – Prescription Drugs
Approved by medicare but administered and created by private health insurance companies. Unlike Part A and B these plans are not standardized. To receive this benefit you must enroll and a pay for a separate Prescription Drug Program (PDP).

Medicare – Supplements or Medigap
Provides coverage to pay for services and products that parts A and B do not cover (holes or gaps). Every
Medigap policy must follow Federal and state laws designed to protect you, and the policy must be clearly identified as  Medicare Supplement Insurance. Medigap insurance companies in most states can only sell you a “standardized Medigap policy identified by letters A through N.  Each standardized Medigap policy must offer the same basic benefits, no matter which insurance company sells it.

With all the changes in medicare, it is important to keep up-to-date. Unfortunately it is not always so simple. Click here for more details from the  Medicare Guide.

This page provided as a courtesy, and not to be relied upon. This covers generally known information which is subject to carrier and governmental regulatory changes.


Peter Green Insurance Agency, an independent agency headquartered in Costa Mesa, Orange County,Ca.
 Serving individual and business clients throughout California.