Medicare, covering 67.2 million Americans, is divided into four parts: Part A (hospital care), Part B (medical services), Part C (Medicare Advantage), and Part D (prescription drugs). Each part offers different benefits and coverage limitations, making it essential for beneficiaries and payers to understand these differences for effective education and care management. Click here for article.
Medicare Part A: Covers hospital stays, skilled nursing facilities, and some home health services but excludes private nursing and custodial care.
Medicare Part B: Provides coverage for outpatient care, durable medical equipment, and preventive services, but does not cover most prescription drugs or certain mental health services.
Medicare Part C (Medicare Advantage): Combines Parts A and B with additional benefits like vision and dental but requires beneficiaries to use network providers and may exclude certain services like hospice care.
Medicare Part D: Focuses on prescription drug coverage with varying formularies and coverage options, and does not cover all drugs, though exceptions can be requested.
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