Have you ever tried reading Medicare pamphlets? Sometimes, they’re written in some secret code that only insurance agents understand! When someone in your family turns 65, the whole family gets pulled into the Medicare maze. 

The biggest question they have is always about Medicare Part A vs Part B vs Part C vs Part D like what’s the difference, and why does it matter? 

After a lot of research, here’s a complete guide for people to learn all about Medicare part a vs Medicare part b and part c and d, so they don’t have to hassle again. Let’s dig straight into the details.

What Is Medicare, Really?

Medicare is basically the government’s health insurance program for folks 65 and up. They also cover some younger people with disabilities and people with kidney failure. 

It’s actually split into four parts: A, B, C, and D. Each covers different stuff, and knowing the difference will definitely save your family thousands of dollars.

Medicare Part A vs Part B: The Main Event

The easiest way to remember the difference? Part A = Hospital, Part B = Doctor visits. That’s how it will stick with you for a long-time. Let’s start by understanding Medicare part a b c d coverage

Medicare Part A: When You’re Stuck in the Hospital

Part A is all about hospital stuff. It covers:

• When you’re admitted to the hospital
• Skilled nursing care (after you’ve been in the hospital)
• Hospice care when things get really serious
• Some home health services when you can’t leave home

Here’s something that surprised me. Most people don’t pay monthly for Part A! According to SSA.gov, If you or your spouse worked and paid Medicare taxes for about 10 years, you get Part A without a monthly premium. You may remember it as your “prepaid plan.” The Social 

But don’t get too excited. There are still costs. In 2025, there’s a $1,676 deductible for each hospital stay, as per cms.gov. And if you’re in the hospital longer than 60 days, you start paying daily coinsurance. Some people find out about this in a hard way after various complications.

Medicare Part B: For When You’re Not in the Hospital

Part B covers pretty much everything else:

• Regular doctor visits
• Specialists
• Outpatient surgeries
• Lab tests
• X-rays and imaging
• Preventive stuff like flu shots
• Medical equipment like wheelchairs or oxygen
• Mental health treatment

Unlike Part A, EVERYONE pays for Part B. Most people pay $185 per month in 2025. 

After you pay the yearly deductible ($257 in 2025), Part B typically covers 80% of approved services. That leaves you paying the other 20%, which can add up fast for expensive treatments especially when comparing Medicare Part A vs Medicare Part B and realizing how differently each handles costs and coverage.

Beyond the Basics: Parts C and D

Once you understand Parts A and B, I thought I was done. Nope! There’s also Part C and Part D to figure out.

Medicare Part C: The All-in-One Package

Part C plans, also called Medicare Advantage, are like the bundle deals of Medicare. They’re offered by private insurance companies but approved by the government.

These plans include:

• Everything from Part A
• Everything from Part B
• Usually prescription drug coverage
• Often extra perks like dental, vision, gym memberships, etc.

The way you can understand it is by explaining it like: Medicare Advantage is like choosing to get your Medicare through a private company instead of directly from the government. You’re still in Medicare, but a private insurer is handling everything.

Medicare.gov gives a good explanation of how these plans work.

Medicare Part D: The Drug Plan

Part D is just for prescription medications. Original Medicare doesn’t cover most prescriptions, which becomes a HUGE shock if you are unaware of the bills.

You can get Part D two ways:

1. As a separate plan if you have Original Medicare
2. Included in most Medicare Advantage plans

The costs vary wildly depending on the plan you choose. In 2025, most plans have:

• Monthly premiums around $85.80
• A deductible 
• Copays or coinsurance that vary by medication

The most confusing part of Part D is something called the “donut hole” or Medicare part d coverage gap. After you and your plan spend $5,030 combined on drugs (in 2025), you hit this gap where you pay more for your medications, typically 25% of the cost.

Once your out-of-pocket spending hits $8,000, you get out of the donut hole and pay a lot less for the rest of the year.

Choosing Between Original Medicare and Medicare Advantage

This might be the biggest decision you will have to face. Would you go with Original Medicare (Parts A & B) plus separate drug coverage? Or a Medicare Advantage plan that includes everything?

Here’s how to understand it in simple words:

Original Medicare

• Use pretty much any doctor or hospital nationwide that accepts Medicare
• No referrals needed to see specialists
• Need to add Part D separately for medications
• No limit on annual out-of-pocket costs unless you buy a supplemental Medigap policy
• Can be more expensive monthly but more flexible

Medicare Advantage

• Usually limited to doctors in your plan’s network
• May need referrals to see specialists
• Drug coverage usually included
• Annual cap on out-of-pocket costs for medical services
• Often lower monthly costs but less flexibility

Medicare.gov has a great comparison tool that shows the differences between these options

Supplemental Coverage: Medigap Policies

If you choose Original Medicare, you might want to look into Medigap. These are extra policies sold by private companies that help cover the “gaps” in Medicare coverage, just like that 20% coinsurance under Part B that has no upper limit!

Medigap plans are standardized and labeled with letters (like Plan G or Plan N). Each plan letter offers specific benefits, no matter which insurance company sells it. The only difference is the price.

Don’t Miss These Deadlines!

If there’s one thing that you should learn about Medicare, it’s that the timing matters, a lot. Here are the key periods to know:

• Your Initial Enrollment Period is 7 months long, 3 months before your 65th birthday month, your birthday month, and 3 months after. This is when most people should sign up.
• If you miss that window, you can sign up during the General Enrollment Period (January 1 – March 31 each year), but you might face late penalties.
• The Open Enrollment Period (October 15 – December 7 each year) lets you change your coverage for the following year.

Penalties That Last Forever

Here’s something for everyone who’s approaching 65: Don’t mess around with Medicare enrollment deadlines unless you’re absolutely sure you should delay signing up!

The penalties are no joke:

• Part B: Your premium goes up 10% for each 12-month period you could have had Part B but didn’t. And it NEVER goes away!
• Part D: You’ll pay 1% more for every month you could have had drug coverage but didn’t.

How to Choose What’s Right for You

After helping three family members navigate Medicare, here’s my advice on figuring out which parts of Medicare make sense for your situation:

1. Think about your doctors, do you need to keep seeing specific providers?
2. Make a list of your prescriptions and their costs
3. Consider your travel habits
4. Be honest about your budget
5. Think about your health conditions and likely medical needs
6. Ask yourself how important predictability is versus flexibility

There’s no one-size-fits-all answer. Your Mom and Dad will make completely different choices, and they’ll both be happy with their coverage.

Final Thoughts: It’s Not a One-Time Decision

The biggest lesson you will learn through this whole process will be that Medicare isn’t a set-it-and-forget-it thing. You and your family must reviews your coverage every year during Open Enrollment because:

• Plans change their costs and benefits
• Health needs change
• New medications might be covered differently
• Better options might become available

Understanding Part A vs Part B Medicare is just the beginning of your Medicare journey. Parts C and D add more options and complexity. But with a little patience and the right resources, you can find Medicare coverage that works for you.

Need more personalized help sorting through the Medicare maze? The team at Senior Services Simplified specializes in helping folks just like you find the right Medicare coverage. They can walk you through your options and help you avoid costly mistakes. Connect today now!