What Does Medicare Cover?
What Does Original Medicare Cover?
Original Medicare includes Part A (Hospital Insurance) and Part B (Medical Insurance), and it forms the core of your Medicare coverage. However, it's important to know that Original Medicare generally only covers about 80% of approved medical costs—leaving you responsible for the remaining 20%, with no out-of-pocket maximum. It also doesn’t include coverage for most prescription drugs, dental, vision, or hearing care. That’s why many people choose to add a Medicare Supplement or Prescription Drug Plan to help fill in the gaps. We’re here to help you make sense of it all and find the coverage that gives you peace of mind.
What is Medicare Part A?
Medicare Part A, also known as Hospital Insurance, helps cover the cost of care when you're admitted to a hospital or skilled nursing facility. It also includes hospice care and some limited home health services. For most people, Part A comes at no cost if you or your spouse paid Medicare taxes while working. While Part A helps cover major healthcare expenses, it doesn't pay for everything—you'll still be responsible for deductibles, coinsurance, and certain limits on coverage. That’s why it’s important to understand how Part A works with the rest of Medicare and what additional coverage you might need to stay fully protected.
What is Medicare Part B?
Medicare Part B, also known as Medical Insurance, helps cover the everyday healthcare services you need to stay healthy and manage chronic conditions. This includes doctor visits, outpatient care, preventive services like screenings and vaccines, lab work, and durable medical equipment such as walkers or wheelchairs. Unlike Part A, Part B does have a monthly premium, which is based on your income. It typically covers 80% of approved medical costs, leaving you responsible for the remaining 20%—with no annual cap on out-of-pocket expenses. Understanding how Part B fits into your overall Medicare coverage is key to making sure you’re prepared for both routine and unexpected healthcare needs.
What is Medicare Advantage (Medicare Part C)?
Medicare Part C, also known as Medicare Advantage, is an alternative to Original Medicare offered through private insurance companies approved by Medicare. These plans combine Part A (hospital) and Part B (medical) coverage into one plan—and many also include Part D (prescription drug coverage), along with extra benefits like dental, vision, hearing, and wellness programs. Medicare Advantage plans often operate within a provider network, which means you may need to see doctors and specialists within that network. These plans can be a great choice if you're looking for all-in-one coverage, but it's important to compare options carefully based on your health needs, budget, and preferred doctors. We’re here to help you sort through the details and find a plan that fits your lifestyle.
What are Medicare Prescription Drug Plans (Medicare Part D)?
Medicare Part D is prescription drug coverage that helps pay for the medications your doctor prescribes. It’s offered through private insurance companies that are approved by Medicare, and you can add it to Original Medicare or some Medicare Advantage plans that don’t already include drug coverage. Part D plans vary in cost and coverage, and will include a formulary—a list of covered drugs—that’s divided into tiers based on the type of medication. You could potentially pay a monthly premium, along with copays or coinsurance for your prescriptions. While Medicare Part D is optional, enrolling when you're first eligible helps you avoid late enrollment penalties down the road. Choosing the right plan can make a big difference in both cost and coverage, and we’re here to help you find one that fits your needs and keeps your medications affordable.
What are Medicare Supplement Plans (Medigap)?
Medicare Supplement Plans, also known as Medigap, are insurance policies offered by private companies that help fill the coverage gaps left by Original Medicare (Parts A and B). While Medicare pays for a large portion of approved healthcare costs, it doesn’t cover everything—things like copayments, coinsurance, and deductibles can still leave you with out-of-pocket expenses. That’s where a Medicare Supplement Plan can help. These plans are designed to work alongside Original Medicare, giving you more predictable healthcare costs and greater peace of mind. One of the biggest advantages of Medigap is that you can see any doctor or specialist who accepts Medicare—no networks, no referrals needed. There are several standardized plans to choose from, each offering different levels of coverage, and we’re here to help you find the one that fits your needs and budget best.
Let Us Help at No Cost!
We’re here to walk you through the process step by step, answer your questions along the way, and help you understand all of your options in a way that actually makes sense. Our goal is to make things simple, clear, and stress-free—so you can feel confident about the choices you’re making.