Now you know: health insurance in simple terms

Millions of people struggle to understand what types of health care coverage there are out there. Health insurance is always on the news. Keeping up with the latest changes and proposals regarding Part A, B, C, and D is not easy. What do all these Parts mean?

Health insurance image - 3939393This article may help you understand what Medicare is all about and how it can help you.

Three simple steps

According to, enrolling in Medicare is a quick and relatively straightforward process. You first need to find out whether you qualify. If you are eligible, your next step is to find out what plan is best for you. When you have found what you are looking for, you need to enroll.

Most Americans qualify for Medicare when they are 65 years old. Some people, such as those with certain disabilities, may be eligible at a younger age. You can enroll in person, online, or on the phone. For some individuals, Medicare enrollment is automatic.

If you do not enroll when you qualify for Medicare programs, you may have to pay a penalty.

Medicare – four parts

Medicare consists of four parts: Part A, Part B, Part C, & Part D.

When people qualify for Medicare, they are typically first enrolled in Part A and Part B.

Medicare Part A

This part applies to hospital insurance. It covers hospital stays as an inpatient, hospice care, nursing care, and also some home health care services. Enrollees usually pay coinsurance, copayments, and a deductible.

In most cases, Part A coverage does not involve paying a monthly premium.

Medicare Part B

This part covers medical insurance and includes:

  • Visits to a doctor’s office.
  • Certain screenings, tests, and other preventive services.
  • Flu and pneumococcal vaccinations.
  • Counseling for alcohol abuse/use.
  • Physical therapy.
  • Outpatient mental health care.
  • Diabetes self-management therapy, screenings, and supplies.
  • Wheelchairs and other durable medical devices and equipment.

Medicare Part C

We also refer to Medical Part C is Medicare Advantage. Private insurance companies that are contracted with Medicare provide policyholders with this coverage.

Medicare Part C covers everything in parts A and B plus more. For example, home health care coverage in Part C is more comprehensive.

Part C covers everything Part B does, including:

  • Lab tests.
  • X-rays.
  • Primary care doctor visits.
  • Specialist doctor visits.
  • Outpatient plus inpatient mental health services.
  • Occupational therapy.
  • Speech and language pathology.
  • Vaccines and preventative tests.
  • Durable medical devices and equipment such as wheelchairs and walkers.
  • Emergency ambulance services.

Regarding Medicare Advantage costs, Maine Medicare makes the following comment:

“The cost, however, can vary. The best plan is to start by determining which level of coverage best fits your needs, and then searching for the best prices and companies from there.”

Health care insurance image 4489489489Medicare Part D

We also refer to this part as the Medicare Prescription Drug Benefit. It is a federal program that private insurance companies administer. Beneficiaries get retail prescription drug coverage.

The policyholder or beneficiary pays a premium each month to an insurance carrier.