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Medicare 101: Understanding Parts A, B, C, and D in Plain English



Navigating Medicare can feel like learning a new language—but it doesn’t have to. If you're approaching age 65, already enrolled, or helping a loved one with their healthcare decisions, this guide will break down the four parts of Medicare in simple terms—no confusing jargon, just what you need to know.

Part A: Hospital Insurance

Think: "Room and Board" at the Hospital


Part A covers most of the costs related to inpatient care, such as:

  • Hospital stays

  • Skilled nursing facility care (after a hospital stay)

  • Hospice care

  • Some home health care

Cost:


Most people don’t pay a monthly premium for Part A if they’ve worked (or their spouse has worked) and paid Medicare taxes for at least 10 years, however there is a coinsurance for days 1-60 for every admittance. When you are discharged from the hospital, there is a new coinsurance cost. For days 61-90 in the hospital, there is a daily copay, which also starts over for every new hospital stay.


Part B: Medical Insurance


Think: "Doctor and Outpatient Visits"


Part B covers outpatient services like:

  • Doctor visits

  • Lab tests and X-rays

  • Preventative services (flu shots, screenings, etc.)

  • Durable medical equipment (like wheelchairs, or oxygen)

  • Some home health services

Cost:

There is a monthly premium for Part B (in 2025, it’s around $185.00 for most people). You may pay more based on your income.


Part C: Medicare Advantage


Think: "All-in-One" Option


Part C (also called Medicare Advantage) is a private insurance plan that bundles Parts A and B—and usually Part D—into one plan.


These plans are offered by insurance companies approved by Medicare. Many offer:

  • Lower out-of-pocket costs

  • Extra benefits (like dental, vision, or gym memberships)

  • Prescription drug coverage (included in most plans)


Cost:

Varies by plan. Some have $0 premiums; others have added costs based on benefits.


Important: You still have to pay your Part B premium even if you’re in a Medicare Advantage plan.


Part D: Prescription Drug Coverage


Think: "Help Paying for Medications"


Part D helps pay for your prescription drugs—including brand-name and generic medications.


You can get Part D in two ways:

  • As a standalone plan with Original Medicare (Parts A & B)

  • Built into a Medicare Advantage plan (Part C)

Cost:

Premiums vary depending on the plan and your prescriptions. Like Part B, you may pay more if your income is higher.

Important Tips:


  • You can enroll in Original, Medicare (A + B) and add Part D separately—or choose a Medicare Advantage (Part C) plan that includes it all.


  • Enrollment begins 3 months before your 65th birthday and ends 3 months after.


  • Late enrollment can lead to penalties, so don’t delay if you’re eligible!

  • You can enroll in Original Medicare ( Parts A & B) and add Part D separately

  • You need both Parts A & B to enroll in a Medicare Advantage Plan

  • You need either Part A or B to enroll in a Medicare Part D Plan

  • Late penalty enrollment - The Part B penalty is enrollment after your initial 7-month period of turning 65, while the Part D penalty is 63 days after losing creditable drug coverage. These are lifetime penalties.


Need Help Choosing the Right Plan?


Choosing the right Medicare coverage depends on your health needs, prescriptions, budget, and preferred doctors or hospitals. At Parkwest Financial Group, we help individuals and families understand their options and enroll in plans that fit their lives. Whether you want to keep your current doctors, find a plan with dental coverage, or lower your medication costs—we’ll walk you through every step.


Contact us today for a free, no-pressure Medicare review.

Your health matters. Let’s make sure your plan works for you—not the other way around.

Click the link below to schedule your free, no-pressure consultation