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Medicare Part A B C D

Medicare is a federal health insurance program for people 65 and older.

Original Medicare is made up of Medicare Part A and B which are provided through the government. Medicare Part C and D are provided through health insurance companies, like us here at Geisinger Health Plan. We offer Geisinger Gold Medicare Advantage plans to our members. 

What are the four parts of Medicare?

Each part covers different services at different costs.

Learn more to understand how each part or a combination of parts could be the right fit for you.

Get to know the Medicare parts by watching our Step-by-Step video.

Medicare Part A - hospital insurance

Medicare Part A does not have a monthly premium; however, if you have less than 10 years of paying Social Security taxes left, you will have to pay a small premium. Part A helps pay for inpatient hospital insurance, covers skilled nursing facility care (only if hospitalized first), home health care if hospitalized and hospice care whether or not you have been hospitalized.

What does Medicare Part A cover?

  • Inpatient care in hospitals
  • Skilled nursing facilities
  • Hospice
  • Home health care

Cost: You must pay a benefit-period deductible before Medicare pays its part. This can change annually. Additional per day copays apply if you are admitted to the hospital and stay there as a patient for more than 60 days.


Medicare Part B - medical insurance

Medicare Part B has a monthly premium. Part B helps pay for outpatient services such as doctors’ fees, outpatient hospital visits, labs, X-rays, ambulance, preventive services, emergency room trips and urgent care visits, as well as other medical services and supplies not covered by Part A.

If you are delaying your retirement and have health insurance with your employer, you can also delay
enrollment in Part B, although it is recommended you enroll in premium-free Part A at age 65.

What does Medicare Part B cover?

  • Doctor services
  • Outpatient care
  • Preventive services

Cost: Once an annual deductible is reached, Medicare will pay 80% of services. You will be responsible for the remaining 20%.


Remember: Original Medicare may not cover everything

If you have a medical condition that requires frequent care or a lengthy stay in a hospital or skilled nursing facility, the cost of Original Medicare can add up quickly. Additionally, it does not provide benefits for many common healthcare services including:

  • Hearing aids
  • Routine hearing exams
  • Eyeglasses
  • Routine eye exams
  • Preventive dental care
  • Most prescription drugs
  • Fitness benefits
  • Worldwide emergency medical coverage 

Ready to shop?

senior couple researching Geisinger Gold Medicare Advantage plans

Medicare Part C - Medicare Advantage

Medicare Part C plans are overseen by Medicare but administered by private companies, such as Geisinger Gold. Medicare Advantage plans provide the same benefits as Original Medicare, but usually with lower costs plus additional services and benefits not covered by Original Medicare. Part C is available to all Medicare beneficiaries living within a plan’s service area who have Medicare Parts A & B and do not have end-stage renal disease.

Medicare Advantage plans, like Geisinger Gold, were created to give Medicare beneficiaries a new way of receiving benefits — offering many choices to find the right fit for your budget and lifestyle.

What extra benefits can Part C Medicare Advantage plans cover?
Medicare Advantage plans cover all the same services as Parts A and B, but may offer extra benefits such as: 

  • Dental, preventative and some non-Medicare covered comprehensive
  • Routine vision, including coverage for eyewear and/or contact lenses
  • Routine hearing and hearing aids
  • Medicare Parts A and B
  • Routine dental
  • Routine vision
  • Hearing aids
  • Fitness benefits
  • Worldwide emergency medical coverage 

Cost: The nice thing about Medicare Advantage plans is that they may have low to zero-dollar premiums. With Medicare Part C, you must have Medicare Parts A and B to qualify to enroll. 


Medicare Part D - Rx

Medicare Part D covers prescription drugs. Without Part D, any medications you may need could cost hundreds or even thousands of dollars. Coverage is available as a stand-alone prescription drug plan (PDP), or as a Medicare Advantage plan with prescription drug coverage (MAPD), but must be purchased through a government sponsored private insurance company that contracts with Medicare, like Geisinger Gold. Part D coverage varies based on plan selection with different formularies (drug list) and options, including varying premiums, copays and coinsurance. To join a PDP or MAPD plan, you need to have Medicare Parts A and B and live in the service area of the plan.

It’s important to enroll in Part D when you are first eligible even if you have little or no prescription drug costs. Similar to Part B, if you do not sign up in your initial eligibility period, the premium will increase for each month until you do enroll. Once you are enrolled, your premium won’t increase with your age and you cannot be denied because of a pre-existing health condition, the number of medications you take or because of your income.

What does Medicare Part D cover? 

  • Brand name prescription drugs
  • Generic prescription drugs

Cost: Part D coverage has an annual premium, and an annual deductible. You can apply for it separately or as part of a Medicare Advantage plan.


Y0032_18270_1_M File and Use 10/1/18

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