Medicare is an important part of any senior citizen (or eligible individual) in one way or another.

That is why it is unfortunate that so many people don’t have a clear understanding of what Medicare is.

It’s critical that people understand what Medicare is and how it can be a great option for those specifically aged at least 65 years old, people with eligible disabilities, and people with end stage renal disease.

Understanding Medicare and How it Could Help

Simply put, Medicare can be understood in 4 parts:

• Hospital Insurance (Part A)
• Doctors and Tests (Part B)
• Medicare Advantage (Part C)
• Prescriptions (Part D)

Hospital Insurance (Part A)

Part A covers many different types of services like:

• Inpatient Care at Specified Locations (Like Hospitals or Religious Non-Medical Healthcare Facilities)
• Surgeries
• Home Healthcare Services
• Hospice Care (Only Medicare-Approved)
• Nursing Facilities

Keep it mind they don’t cover everything, but they cover after you handle a certain amount.

For 2026, the amount is $1,736.

Doctors and Tests (Part B)

Another important part of Medicare is Part B.

This is important because it covers a variety of services which include:

• Ambulance Services
• Cancer Treatment
• Cardiac Rehabilitation
• Clinical Research
• Doctor’s Visits
• Durable Medical Equipment (DME)
• Mental Health
• Outpatient Services
• Preventative Services
• Purchase of Blood

If an individual has another source of creditable coverage then they will not be required to have Part B.

Creditable coverage can be provided from sources like an employer.

If you do not have this creditable coverage and do not enroll in Part B then you may be subject to penalties if you choose to enroll at a later date.

Understanding Part A and B Coverage (What Does it Mean to You)

Medicare Parts A and B are a great foundation of a health insurance plan.

However, just having these two parts may not be the best option for individuals that want to have adequate long-term care coverage.

Individuals with chronic conditions that require a hefty load of care will likely not feel the ease of mind of sufficient coverage.

This can make it hard for people with Medicare because it’s not uncommon to see people need long-term care for the remainder of their lives.

These parts don’t provide coverage for:

• Acupuncture
• Cosmetic Surgery
• Dentures
• Eye Care
• Hearing Aids
• Long-Term Care
• Most Dental Care
• Routine Foot Care

Medicare Advantage (Part C)

Also known as Medicare Advantage, Part C essentially acts like another option compared to traditional Medicare coverage.

Typically, this coverage consists of all parts (Parts A, B, and D) along with some other benefits (depending on the plan you choose).

This part is provided by Medicare-approved private insurance companies.

Prescriptions (Part D)

Medicare Part D focuses on prescription drug coverage.

Part D is not the same as Parts A and B because it is only administered by private insurance companies.

This coverage is not required (like with Part B) and is entirely optional.

Since every plan is unique, you will be able to confirm the specific terms when going through the process of getting this insurance plan.

Understanding Medicare

Now that you have a basic understanding of the different parts of Medicare, you can begin to learn what Medicare means and how it can be beneficial.

Traditional Medicare

Also referred to as Original Medicare, this plan coverage works very simply.

It is based on the fact that a service is exchanged for a fee.

This means that when an individual receives a medical treatment done by a doctor or hospital, then Medicare is responsible for paying a portion.

The portion that Medicare pays is only for the Medicare-covered services.

Any other expenses from non-Medicare-covered services are the responsibility of the covered individual.

People usually handle these costs with other insurance coverage that are designed to handle the expenses that traditional Medicare doesn’t cover.

What’s the Difference Between Medicare and Medicaid?

A lot of Americans confuse these two options because they have similar names.

However, there is a difference which is important to know so that you can have a clearer understanding of Medicare.

Medicare is a government health insurance program for individuals at least 65 years old, individuals with an eligible disability, and those with permanent kidney failure that requires dialysis or a kidney transplant.

On the other hand, Medicaid is a state and government funded assistance program that aims to provide health coverage to individuals that meet financial qualification requirements.

Overall

Medicare isn’t as simple as most people think it should be.

To better understand Medicare, you should break it down into four parts to better know the coverage you will receive.

Traditional Medicare (also referred to as Original Medicare) consists of Part A and Part B (if you don’t have a source of creditable coverage).

There are other optional parts that you can get like Parts C and D.

Consider Medicare when looking for support options!