Medicare can seem confusing at first, but it’s really just a system of parts that work together. Each part covers different services—from hospital stays to prescription drugs. This guide breaks down the basics so you can better understand how Medicare is organized and what each part is designed to do.
What it covers:
Inpatient hospital care
Skilled nursing facility care (short-term)
Hospice care
Some home health care
What you’ll pay in 2025:
Premium: $0 for most people (if you or your spouse worked 10+ years)
Deductible: $1,676 per benefit period
Coinsurance:
Days 1–60: $0
Days 61–90: $419/day
Days 91+: $838/day (lifetime reserve days apply)
Why it matters: Part A helps cover big medical events—like surgeries or long hospital stays—that could otherwise cost thousands out of pocket.
What it covers:
Doctor visits
Outpatient services (like lab tests and X-rays)
Preventive services (like flu shots and cancer screenings)
Durable medical equipment (like wheelchairs)
What you’ll pay in 2025:
Premium: Starts at $185/month (can be higher based on income)
Deductible: $257/year
Coinsurance: Usually 20% of approved services
Why it matters: Part B helps with the day-to-day care you’re more likely to use—like seeing your doctor or getting tests done.
What it covers:
Includes everything in Parts A and B
Often includes Part D (drug coverage)
May add extras like dental, vision, hearing, and gym memberships
What you’ll pay in 2025:
Premiums: Some plans are $0/month (you still pay Part B premium)
Out-of-pocket costs: Vary by plan but must have an annual limit
Why it matters: Medicare Advantage plans are private alternatives to Original Medicare. They bundle coverage into one plan and often include extras not covered by Parts A or B.
What it covers:
Prescription medications
Drugs grouped into tiers (generics usually cost less)
What you’ll pay in 2025:
Premium: Varies by plan and location
Deductible: Up to $590 in 2025, depending on the plan
Copays/Coinsurance: Based on your specific drugs and plan
Out-of-Pocket Cap: New for 2025 – your yearly out-of-pocket spending is capped at $2,000
Why it matters: Original Medicare doesn’t cover prescriptions. Part D helps pay for your medications, which can be a big part of your health care costs.
| Part | What It Covers | Offered By | Drug | Premium |
|---|---|---|---|---|
| A | Hospital, nursing care | Federal govt | ❌ No | Usually $0 |
| B | Doctor, outpatient care | Federal govt | ❌ No | Starts at $185 |
| C | A & B + D + extras | Private insurer | ✅ Usually | Varies, some as low as $0 |
| D | Prescription drugs | Private insurer | ✅ Yes | Varies by plan/location |
You don’t have to enroll in every part. The right mix depends on your health needs and budget.
If you want basic coverage, Parts A and B (Original Medicare) may be enough.
If you want prescription coverage too, you’ll need Part D or a Medicare Advantage plan that includes it.
If you want one plan that includes everything, consider Part C (Medicare Advantage).
Understanding the parts of Medicare is a big first step. But choosing the best coverage for your needs? That’s where we come in. At Graham Life Services, we take the time to explain your options in plain language and help you make a confident choice—without pushing you into something that’s not right for you.
We’re here to make Medicare easier.
Not Sure What Coverage You Need?
Get expert help—schedule a quick call with us.
