There are many ways to have Medicare coverage. Two of the most popular coverage options are Original Medicare (Part A and Part B) with a supplement and separate prescription drug plan (Part D), or an all-in-one Medicare Advantage plan (Part C). Let’s break down everything you need to know.

What is Medicare?

Medicare is a federal health insurance program for people age 65 and older, as well as younger people with certain disabilities or end-stage renal disease. Medicare has four parts and each one covers different healthcare services.

What are the four types of Medicare coverage?

Medicare Part A
Medicare Part A helps cover inpatient hospital care, skilled nursing facilities, hospice care and home healthcare. Typically, there is no monthly premium for Part A if you or your spouse paid Medicare taxes for a length of time while working, but some people do pay a monthly premium.

Medicare Part B
Medicare Part B helps cover outpatient care, most preventive care (e.g., screenings, vaccines, wellness visits), medically necessary services from doctors and other healthcare providers, and certain medical supplies and equipment. Part B typically has a standard premium that must be paid each month.

Original Medicare is another name for Medicare Part A and Part B. It covers most medically necessary services but not the full cost of routine care. It also doesn’t provide vision, dental or other benefits.

With Original Medicare, you pay for services as you need them. It includes a deductible as well as a 20% coinsurance cost for all Medicare-approved services and supplies. Drug coverage is not available through Original Medicare and instead would need to be added through a Medicare Part D plan.

Medicare Part C, also called Medicare Advantage (MA)
MA is a Medicare-approved private health insurance alternative that takes the place of Medicare Parts A and B. You’re still in the Medicare program, with Medicare rights and protections including complete Parts A and B coverage, plus extras.

Not all MA plans work the same. Most offer additional coverage that is not provided through Original Medicare, such as vision, dental, fitness incentives, care for chronic illnesses and even drug coverage.

What you pay and how you get services with an MA plan depends on a variety of factors. Most often, MA plans set a limit on the amount you pay out-of-pocket each year for covered services. It’s common for MA plans to require you to use participating providers, meaning healthcare providers who participate in the plan’s network, to pay the lowest cost.

Some plans won’t cover services from providers outside the plan’s network and service area. However, there are MA plans with out-of-network coverage, but often you would pay a higher out-of-pocket cost.

In addition, MA plans generally have much lower premiums or no premiums at all. If an MA plan includes prescription drug coverage, you don’t need to pay for a separate Part D plan. However, no matter which MA plan you choose, you will still pay a Part B premium.

Medicare Part D

Medicare Part D is prescription drug coverage to help you with the cost of medication and vaccinations. Part D plans are offered through Medicare-approved private health insurance companies and have a monthly premium.

If you have an MA plan that includes coverage for prescription drugs, you cannot add separate Part D coverage.

Medicare Supplement Insurance, also called Medigap

Medigap is a supplemental plan option to help pay for additional out-of-pocket costs like your deductible, copays and coinsurances. Some Medigap plans also provide benefits for services not covered through Original Medicare, such as coverage when traveling internationally.

Premiums for Medigap plans can be based on age, gender or tobacco status. They are generally more expensive than MA plans, and the premium increases with your age.

With a Medigap plan, you still need to pay your Part B premium. And, if you don’t have other creditable prescription drug coverage, you will want to enroll in a separate Part D plan to help with prescription drug costs.

What’s the process of enrolling in Medicare?

When and how to enroll in Medicare varies as some people are automatically enrolled while others must sign up for it. If you already get Social Security or Railroad Retirement Board (RRB) benefits, you will automatically be enrolled into Parts A and B starting the first day of the month you turn age 65. For anyone whose birthday falls on the first of the month, Medicare coverage will start the first day of the month before your birthday. You can opt out of automatic enrollment by contacting Social Security or the RRB.

Anyone with a qualifying disability will automatically be enrolled into Medicare Parts A and B after they’ve received disability benefits from Social Security or the RRB for 24 months. If you have end-stage renal disease, you will need to contact Social Security to determine how and when you can sign up.

Those who are turning age 65 and don’t have Social Security or RRB benefits will need to sign up for Medicare during an enrollment period.

Working past age 65? Learn more about your options.

How to choose the best Medicare plan for you

It’s important to compare your options so you can find the best coverage for your needs and sign up on time. If you don’t sign up for Part B when first eligible, there may be a delay of your Medicare coverage in the future – up to one year or longer. Plus, you could also have to pay a late enrollment penalty for as long as you are enrolled in Part B.

Every year during the open enrollment period from Oct. 15 to Dec. 7, you can join, switch or drop your Medicare coverage. Any changes you make will go into effect beginning Jan. 1 of the next year.

Download a free guide to Medicare Advantage plans from MyAdvocate Medicare Advantage.

For more information, contact a licensed agent at (888) 535-4831 (TTY: 711) Monday through Friday between 8 a.m. and 8 p.m. CT, excluding holidays.

Last Updated On: 7.20.26 at 1:00 PM