What is Medicare

Medicare is the Federal health insurance program for:

People who are age 65 or older
Certain younger people with disabilities
People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

The different parts of Medicare help cover specific services:

In general, Part A covers:

Inpatient care in a hospital
Skilled nursing facility care
Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)
Hospice care
Home health care

Part B covers:

Medically necessary services received from a doctor or medical clinic
Preventive services
Clinical research
Ambulance services
Durable medical equipment (DME)
Mental health
Partial hospitalization
Limited outpatient prescription drugs (Part B)

Medicare Part C:

Medicare Part C is another name for Medicare Advantage. Medicare Part C is administered by private insurance companies contracted with Medicare. Medicare Part C covers everything that original Medicare (Part A and Part B) cover and may cover extra benefits as well.

Medicare Part D:

It is an optional prescription drug program for people on Medicare. Medicare Part D is simply insurance for your prescription medication needs. You pay a monthly premium to an insurance company for your Part D plan. In return, you use the insurance carrier’s network of pharmacies to purchase your prescription medications.

Medicare Part A (Hospital Insurance):

Hospital inpatient stay $1,676 deductible for each benefit period
Days 1–60: $0 coinsurance for each benefit period
Days 61–90: $419 coinsurance per day of each benefit period
Days 91 and beyond: $838 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime). You are responsible for all costs beyond lifetime reserve days
Skilled nursing facility stay. Days 1–20: $0 for each benefit period. Days 21–100: $209.50 coinsurance per day of each benefit period.

Medicare Part B (Medical Insurance):

In 2025, you will pay $257 for your Part B deductible.
After you meet your deductible for the year, you typically pay 20% of the Medicare-approved amount for services like: doctor services, outpatient therapy, durable medical equipment (DME), Part B medications and outpatient hospital services.
You will pay $0 for Medicare-approved clinical labs and Medicare approved home health care services

This is a summary of Medicare. Medicare has neither reviewed nor endorsed this information. For a complete listing of covered services and plans in your area please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week, or consult www.medicare.gov

“We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-Medicare to get information on all of your options”.