Medicare Part A (hospital insurance) is one part of Original Medicare and covers many inpatient services. Medicare Part C (Medicare Advantage) is an alternative coverage option to Original Medicare that is provided by private insurance companies.
Original Medicare consists of Part A and Part B. These two parts cover many inpatient and outpatient treatments and services.
Medicare Part C (Medicare Advantage) plans have to provide the same coverage as Original Medicare. These plans also typically offer additional benefits that are not covered by Original Medicare.
Glossary of common Medicare terms
- Out-of-pocket cost: This is the amount you pay for care when Medicare doesn’t pay the full cost or offer coverage. It includes premiums, deductibles, coinsurance, and copayments.
- Premium: This is the monthly amount you pay for Medicare coverage.
- Deductible: This is the annual amount you must spend out of pocket before Medicare begins to cover services and treatments.
- Coinsurance: This is the percentage of treatment costs you’re responsible for paying out of pocket. With Medicare Part B, you typically pay 20%.
- Copayment: This is a fixed dollar amount you pay when receiving certain treatments or services. With Medicare, this often applies to prescription medications.
Medicare Part A, also known as hospital insurance, covers inpatient care at hospitals and skilled nursing facilities.
Medicare covers inpatient hospital care when:
- You are admitted as an inpatient on a doctor’s orders.
- The hospital accepts Medicare.
Medicare Part A also covers:
- skilled nursing facility care
- hospice care
- some home healthcare
- skilled care at a nursing home on a short-term basis
- inpatient behavioral and mental health care
Medicare Part C, also known as Medicare Advantage, is an alternative coverage option to Original Medicare (Part A and Part B).
Medicare Advantage plans are provided by Medicare-approved private insurance companies and bundle the coverage that is offered by Original Medicare. This means Medicare Advantage plans offer the same coverage as both Part A and Part B.
Medicare Advantage also often includes prescription drug coverage (Part D) as a part of a bundled coverage plan. They also typically offered additional benefits not covered by Original Medicare, such as:
- vision
- dental
- hearing
- fitness programs (Silver Sneakers)
| Part A | Part C |
|---|---|
| It is one part of Original Medicare (Part A and Part B). | It is an alternative to Original Medicare, provided by private insurance companies. |
| It covers inpatient care and treatment at hospitals and various other facilities. | It offers the same coverage as Original Medicare. |
| You can purchase a separate prescription drug plan (Part D). | Plans often come with prescription drug coverage. |
| You can purchase a Medicare supplement insurance plan (Medigap). | You cannot purchase Medigap. |
| You can use any doctor or hospital that accepts Medicare. | You often have to be seen by a doctor that is in the insurer’s network. |
| You pay no monthly premium if you meet the work quarter requirements (40 quarters or 10 years). | Monthly premiums vary by plan. |
| It does not offer coverage for things like vision, dental, and hearing. | Plans may offer additional benefits not covered by Original Medicare. |
You are responsible for paying certain out-of-pocket costs with either Part A or Part C.
Part A costs
The following table shows the costs for Medicare Part A:
| Amount you pay | |
|---|---|
| Premium | ?$0 per month for most people (worked and paid Medicare taxes for at least 10 years) ?$285 or $518 per month if you are not eligible for premium-free Part A |
| Deductible | $1,676 per benefit period |
| Inpatient stays copayments | ?days 1 to 60: $0 after deductible is met ?days 61 to 90: $419 per day ?days 91 to 150: $838 per day while using lifetime reserve days ?after day 150: all costs |
Part C costs
The following table shows the costs for Medicare Part C:
| Amount you pay | |
|---|---|
| Premiums and other costs (copayments, deductibles, and coinsurance) | ?varies by plan ?must pay the Part B premium of $185 |
| Out-of-pocket limit | ?varies by plan ?can’t exceed $9,350 |
You can find Medicare Advantage plans and their costs in your area by using the Medicare online search tool.
Medicare Part A is one part of Original Medicare and offers coverage for various inpatient treatments and services. Medicare Part C (Medicare Advantage) is an alternative to Original Medicare that provides the same coverage, as well as prescription drug coverage (Part D) and additional benefits.
Most people do not pay a premium for Part A. However, you still have out-of-pocket costs like deductibles and copayments. The costs of Part C vary by plan.