Medicare Parts A, B, C & D: What Each One Covers
One of the most common questions we hear is: "Why does Medicare have so many parts?" Fair question. It can feel like you're reading an eye chart instead of a health plan.
But once you know what each letter means, it all starts to click. Let's walk through them one at a time.
Part A: Hospital Insurance
Part A is your hospital coverage. If you need to be admitted to a hospital, Part A is the part of Medicare that kicks in.
What Part A covers:
- Inpatient hospital stays
- Skilled nursing facility care (after a qualifying hospital stay)
- Hospice care
- Some home health services
What Part A does NOT cover:
- Long-term care or custodial care (like help with bathing or dressing)
- Doctor visits during a hospital stay (that's Part B)
- Private-duty nursing
Cost: Most people pay $0 in premiums for Part A because they or their spouse paid Medicare taxes for at least 10 years (40 quarters). However, there is a deductible -- in 2026, the Part A inpatient hospital deductible is $1,676 per benefit period.
Think of Part A as your "big event" coverage. You hope you don't need it, but you're glad it's there.
Part B: Medical Insurance
Part B handles the everyday medical stuff that happens outside a hospital. If Part A is for the big events, Part B is for everything in between.
What Part B covers:
- Doctor's office visits
- Outpatient care and surgeries
- Preventive services (annual wellness visits, flu shots, screenings)
- Durable medical equipment (wheelchairs, walkers, oxygen)
- Mental health services
- Ambulance services
What Part B does NOT cover:
- Most dental care
- Eye exams for glasses
- Hearing aids and fitting exams
- Routine foot care
- Most cosmetic surgery
Cost: The standard Part B premium for 2026 is $185 per month. Higher earners may pay more through an income-related adjustment. There's also an annual deductible of $257 before Part B starts covering its share.
Part B covers roughly 80% of approved services after you meet the deductible. You're responsible for the remaining 20% -- which is one reason many people add supplemental coverage.
Part C: Medicare Advantage
Here's where things get interesting. Part C isn't a separate benefit -- it's an alternative way to get your Part A and Part B coverage. Instead of going through the government directly (Original Medicare), you get your benefits through a private insurance company.
What Part C typically covers:
- Everything Part A and Part B cover (it has to, by law)
- Often includes Part D drug coverage built in
- Many plans add extras like dental, vision, and hearing
- Some plans offer gym memberships, grocery allowances, and transportation benefits
What to watch for:
- Most Medicare Advantage plans use networks (HMO or PPO), so you may need to use specific doctors and hospitals
- Out-of-pocket maximums vary by plan
- Referrals may be required for specialists (especially with HMO plans)
Cost: Many Medicare Advantage plans have $0 monthly premiums (on top of your Part B premium, which you still pay). But costs at the point of care -- copays, coinsurance -- vary by plan.
Medicare Advantage plans are popular for a reason: they often bundle everything into one plan with extra perks. But they're not the right fit for everyone. It really depends on your healthcare needs, your doctors, and where you live.
Part D: Prescription Drug Coverage
Part D helps pay for your medications. Whether you take one prescription or twelve, Part D can make a real dent in your drug costs.
What Part D covers:
- Brand-name and generic prescription drugs
- Each plan has a formulary (a list of covered drugs), so coverage varies
- Vaccines recommended by ACIP (like shingles and RSV vaccines) with $0 cost sharing
What Part D does NOT cover:
- Over-the-counter medications (generally)
- Drugs not on your plan's formulary
- Medications covered under Part A or Part B (like drugs administered during a hospital stay)
Cost: Premiums vary by plan and region. In 2026, the big news is the $2,000 annual cap on out-of-pocket drug spending. Once you've spent $2,000 on covered drugs in a year, you pay $0 for the rest of the year. This is a game-changer for people on expensive medications.
You can get Part D as a standalone plan added to Original Medicare, or it can come bundled into a Medicare Advantage plan (Part C).
How the Parts Work Together
Here's the simple way to think about it:
- Original Medicare = Part A + Part B (and you can add a Part D plan and/or a Medigap supplement)
- Medicare Advantage = Part C (which bundles A + B, usually includes D, and often adds extras)
There's no single "best" option. It depends on your health, your medications, your budget, and your preferred doctors. The goal is finding the combination that gives you the best coverage for the least stress.
Need Help?
Still not sure which parts you need or how they fit together? That's completely normal. At Insuras Health Benefits, we walk you through each option, side by side, so you can make a confident choice.
Let's talk. Schedule a free consultation and we'll help you find the right Medicare setup for your situation. No confusing jargon, no surprises -- just clear answers.