Understanding Medicare

What’s Medicare? 

Medicare is health insurance for people 65 or older, people under 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant).

Medicare Part A (Hospital Insurance) helps cover: 

• Inpatient care in hospitals 

• Skilled nursing facility care 

• Hospice care 

• Home health care 

Medicare Part B (Medical Insurance) helps cover: 

• Services from doctors and other health care providers 

• Outpatient care 

• Home health care 

• Durable medical equipment 

• Some preventive services 

Medicare Part C (Medicare Advantage Plans) 

• Includes all benefits and services covered under Part A and Part B 

• Usually includes Medicare prescription drug coverage (Part D) as part of the plan 

• Run by Medicare-approved private insurance companies 

• May include extra benefits and services for an extra cost 

Medicare Part D (Prescription Drug Coverage) 

• Helps cover the cost of prescription drugs

• Run by Medicare-approved private insurance companies

• May help lower your prescription drug costs and help protect against higher costs in the future

Other Medicare health plans

 Some types of Medicare health plans that provide health care coverage aren’t Medicare Advantage Plans but are still part of Medicare. Some of these plans provide Part A and/or Part B coverage, and some also provide Medicare prescription drug coverage. These plans have some of the same rules as Medicare Advantage Plans. Some examples include Medicare Cost Plans, Demonstration or Pilot Programs, and Programs of All-inclusive Care for the Elderly (PACE). 

Note: Medicare models, demonstrations, and pilot programs, sometimes called “research studies,” are special projects that test improvements in Medicare coverage, payment, and quality of care. They usually operate only for a limited time for a specific group of people and/or are offered only in specific areas. Check with the model, demonstration, or pilot program for more information about how it works. To find out about current Medicare models, demonstrations, and pilot programs, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. 

Extra Help paying for prescription drugs is available. People with Medicare who have limited income and resources may qualify for Extra Help to cover prescription drugs for little or no cost. If you think the person you’re caring for may qualify for Extra Help, visit Socialsecurity.gov. or call 1-800-772-1213. TTY users should call 1-800-325-0778.