Medicare Basics
Learn Medicare
Before comparing plan letters, it helps to understand what Original Medicare pays and what it leaves to you.
The four parts of Medicare
Part A — Hospital Insurance
Helps cover inpatient hospital stays, skilled nursing facility care following a qualifying stay, hospice, and some home health care. Most people pay no premium for Part A because of their work history, but Part A still carries a deductible per benefit period and coinsurance for long stays.
Part B — Medical Insurance
Helps cover doctor visits, outpatient care, preventive services, lab work, and durable medical equipment. Part B has a monthly premium, an annual deductible, and generally leaves you responsible for roughly 20% coinsurance on approved services with no annual out-of-pocket maximum.
Part C — Medicare Advantage
A private plan alternative for receiving Part A and Part B benefits, usually with networks, plan-set copays, and an annual out-of-pocket maximum. You cannot use a Medigap policy to pay Medicare Advantage cost sharing.
Part D — Prescription Drug Coverage
A separate private plan for outpatient prescription drugs. Medigap policies sold today do not include drug coverage, so Part D is its own decision with its own enrollment timing and potential late enrollment penalty.
What Medicare doesn't cover
Nothing is covered at 100%. These are the gaps that most often surprise people in their first year on Medicare.
- The Part A deductible for each benefit period
- The annual Part B deductible
- Roughly 20% coinsurance on most Part B services, with no annual cap
- Skilled nursing facility coinsurance after day 20
- Most routine dental, vision, and hearing care
- Most care received outside the United States
- Long-term custodial care
Original Medicare vs Medicare Advantage
Two different structures, each with trade-offs. Neither is universally right, and this site focuses on educating you about the Medicare Supplement path.
Original Medicare + Medigap + Part D
You keep Original Medicare and add a standardized supplement that helps pay eligible out-of-pocket costs. Any provider nationwide accepting Medicare assignment can be used, and there are no plan networks or referrals. You pay separate premiums for the supplement and for Part D.
Medicare Advantage
A private plan administers your Part A and Part B benefits, typically with a provider network, plan-set copays, prior authorization rules, and an annual out-of-pocket maximum. Drug coverage is often bundled. Plan details are reviewed annually.