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Medicare Parts vs. Plans

When we give thought to Medicare, we often think about a myriad of lettered plans and parts. This can become confusing to those who are not well versed in Medicare terminology as the two are not interchangeable. However, it is essential to understand the difference between Medicare parts and plans to make an educated decision about your healthcare needs.

Once you understand how the two work separately, you can better understand how they work together to form your healthcare coverage. However, as perplexing as it may seem, deciphering between the parts and plans of Medicare is an easy feat to overcome.

The Parts of Medicare

Original Medicare consists of four parts. These include Part A, Part B, Part C, and Part D. These Parts, offered through the government, give beneficiaries an array of coverage from health to prescription drugs. When initially enrolling in Medicare, beneficiaries have the option to enroll in all parts. No part of Medicare is mandatory. However, you could face penalties in the future if you delay enrollment.

  • Part A offers hospital coverage to enrollees. This includes inpatient care, skilled nursing facilities, home healthcare, and hospice care. Part A contains a per-occurrence deductible that beneficiaries must meet for each coverage period.
  • Part B handles doctor’s visits, durable medical equipment, and outpatient care. Part B has an annual deductible that restarts at the beginning of each year. After meeting the deductible, part B requires a 20% coinsurance at the beneficiary’s responsibility.
  • Part C combines Part A, Part B, and sometimes Part D coverage through a private insurer to create an all-in-one plan. This is known as Medicare Advantage. Part C can contain a range of copays, deductibles, and coinsurances depending on the plan and carrier you choose.
  • Part D helps cover the cost of prescription medications. Part D can have copays for medications at the pharmacy.

The Plans of Medicare

Like Medicare Parts, there are several lettered Medicare Supplemental Plans. Through private insurance companies, Medicare Supplements offer Ten Lettered Plans ranging from Plan A to Plan N. Unlike Medicare Parts, there are no penalties for late enrollment into a supplement plan.

Supplemental plans work alongside Original Medicare to fill the gaps in coverage. Each plan offers a different coverage level, and the best plan for you depends on your individual needs.

As mentioned, there are ten lettered supplement plans available. However, most people are enrolling into one of three. Plan F, Plan G, and Plan N are the three most popular supplemental plans.

  • Plan F is the most comprehensive Medicare plan on the market. This plan covers the gap left behind my original Medicare, including Part A and Part B deductibles and coinsurance. At this time, those new to Medicare after January 1, 2020, are not eligible to enroll in the plan.
  • Plan G is the most popular Medicare Supplement. Like Plan F, Plan G covers the cost left behind by Original Medicare. The difference here is that Plan G leaves the policyholder responsible for the Part B deductible. Once met, the plan picks up any remaining Medicare-covered costs.
  • Plan N is similar to Plan G, offering the same coverage with minor differences. With Plan N, the beneficiary is responsible for the Part B deductible. However, you could be charged copays up to $50 when going to the doctor and hospital. This plan is ideal for those not regularly visiting the doctor or hospital.

How to Use Medicare Parts and Plans Together

When combined, Medicare parts and plans create extended health care for beneficiaries. While using Medicare parts and plans, beneficiaries can go to any Medicare accepting doctor or hospital nationwide. There are never any network restrictions or referrals.

To enroll in a Medicare Plan, you must be enrolled in Part A and Part B of Original Medicare, as the plans supplement those benefits. The best time to enroll in a supplement plan is during your Open Enrollment Period. This period begins six months before your Part B start date. During this time, pre-existing conditions are not considered, and you can enroll in any plan you choose.

Medicare Parts vs Plans