Introduction
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?
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 – Hospital Insurance
Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice, and home
health services. This part is often premium-free if you or your spouse have worked and paid
Medicare taxes for a certain period (usually 10 years).
What Part A Covers
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
Cost and Considerations
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 – Medical Insurance
What Part B Covers
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
Cost and Considerations
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.
Medicare Part C – Medicare Advantage
What Part C Covers
These plans include:
- Everything from Part A
- Everything from Part B
- Usually prescription drug coverage
- Often extra perks like dental, vision, gym memberships, etc.
Cost and Considerations
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 – Prescription Drug Coverage
What Part D Covers
You can get Part D two ways:
- As a separate plan if you have Original Medicare
- Included in most Medicare Advantage plans
Cost and Considerations
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
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.
Conclusion
Choosing the Right Combination
Factors to Consider
Healthcare Needs
Evaluate current health, anticipated needs, and coverage requirements.
Prescription Medications
If you require specific medications, consider a Part D or Medicare Advantage plan with drug coverage.
Financial Considerations
Review monthly premiums, out-of-pocket costs, and budget for any additional expenses
Flexibility and Network Preferences
If you want the flexibility of choosing providers, Original Medicare (Parts A and B) plus a Medigap policy may be beneficial; if you prefer bundled coverage with added benefits, Medicare Advantage might be the right choice.
Flexibility and Network Preferences
If you want the flexibility of choosing providers, Original Medicare (Parts A and B) plus a Medigap policy may be beneficial; if you prefer bundled coverage with added benefits, Medicare Advantage might be the right choice.
Examples of Popular Combinations
Original Medicare (Parts A & B) + Part D
Ideal for those who prefer flexibility and don’t need additional benefits.
Medicare Advantage (Part C) with Prescription Coverage
Comprehensive option with added benefits.
Original Medicare + Medigap Policy + Part D
Provides added coverage for out-of-pocket costs not covered by Medicare and includes prescription coverage.
