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Medicare General Information

Medicare General Information

Understanding Medicare: Parts A, B, C & D Explained

A plain-language guide to what Medicare covers, what it costs in 2026, and how to find the enrollment path that fits your situation.

Part A — Hospital Part B — Medical Part C — Medicare Advantage Part D — Prescription Drugs 2026 Costs
A Hospital Insurance

Covers inpatient hospital stays, skilled nursing, hospice, and limited home health care.

$0 premium for most people
B Medical Insurance

Covers doctor visits, outpatient services, preventive care, and durable medical equipment.

From $202.90/mo (income-based)
C Medicare Advantage

Private plan alternative bundling Parts A & B—often with D, dental, vision, and more.

Varies by plan
D Prescription Drugs

Covers generic and brand-name prescription medications. Higher earners pay an IRMAA surcharge.

Plan premium + any IRMAA

Medicare Part A

Part A: Hospital Insurance

Part A is the foundation of Medicare, covering the costs associated with inpatient hospital care. For most beneficiaries it comes at no cost, as long as you or your spouse paid Medicare taxes for at least 10 years.

  • Inpatient hospital stays
  • Skilled nursing facility care (not long-term or custodial care)
  • Hospice care
  • Limited home health care services
2026 Part A Premiums

$0/month: 40+ quarters (10+ years) of Medicare-taxed work
$311/month: 30 to 39 quarters (7.5-9.75 years)
$565/month: fewer than 30 quarters

Deductibles and coinsurance apply for extended hospital stays.

Medicare Part B

Part B: Medical Insurance

Part B covers the outpatient side of healthcare. Things like routine doctor visits, preventive screenings, mental health services, and the medical equipment you may need at home. Unlike Part A, everyone pays a premium for Part B, and the amount depends on your income.

Part B covers things like:

  • Doctor visits and outpatient services
  • Preventive services (screenings, vaccines)
  • Mental health services
  • Durable medical equipment (e.g., wheelchairs)
  • Ambulance services

Part B does not cover extra benefits like dental, vision, or hearing. Those are only available through Medicare Advantage (Part C) plans.

2026 Part B Premiums (based on 2024 income)

Individual Income Joint Income Married & Filing Separately Monthly Premium
$0 - $109,000 $0 - $218,000 $0 - $109,000 $202.90
$109,001 - $137,000 $218,001 - $274,000 N/A $284.10
$137,001 - $171,000 $274,001 - $342,000 N/A $405.80
$171,001 - $205,000 $342,001 - $410,000 N/A $527.50
$205,001 - $500,000 $410,001 - $750,000 $109,001 - $391,000 $649.20
$500,001 and above $750,001 and above $391,001 and above $689.90
2026 Part B Deductible & Coinsurance

$283 annual deductible, then 20% coinsurance after the deductible is met.

Medicare Part C

Part C: Medicare Advantage

Medicare Advantage is a private insurance alternative to Original Medicare. These plans must cover everything Parts A and B cover, and most include Part D drug coverage as well. Many go further by adding dental, vision, hearing, fitness memberships, transportation, and more.

To enroll in a Part C plan, you must already be enrolled in both Part A and Part B.

  • Combines Parts A and B (and often D) in a single plan
  • Extra benefits: dental, vision, hearing, fitness, transportation
  • Special Needs Plans (SNPs) for dual-eligible, low-income, and chronically ill beneficiaries
  • Costs include Part A & B premiums plus plan-specific Part C & D premiums, if any
  • Some plans offer subsidies that reduce your Part B premium
Special Needs Plans (SNPs)

SNPs are tailored Medicare Advantage plans for people with specific circumstances: dual eligibility (Medicare + Medicaid), low-income subsidy (LIS) / Extra Help, long-term care needs, or chronic and disabling conditions.

Medicare Part D

Part D: Prescription Drug Coverage

Part D reduces the cost of both generic and brand-name prescription medications. Plans are offered by private insurers and premiums vary by plan. If your income exceeds certain thresholds, Medicare adds an Income-Related Monthly Adjustment Amount (IRMAA) surcharge on top of whatever your plan charges.

  • Covers generic and brand-name prescription drugs
  • Available as a standalone plan (with Original Medicare) or bundled into a Medicare Advantage plan
  • Higher-income enrollees pay an additional IRMAA surcharge

2026 Part D IRMAA Surcharge (based on 2024 income)

Individual Income Joint Income Married & Filing Separately Monthly Surcharge
$0 - $109,000 $0 - $218,000 $0 - $109,000 Plan premium only
$109,001 - $137,000 $218,001 - $274,000 N/A +$14.50
$137,001 - $171,000 $274,001 - $342,000 N/A +$37.50
$171,001 - $205,000 $342,001 - $410,000 N/A +$60.40
$205,001 - $500,000 $410,001 - $750,000 $109,001 - $391,000 +$83.30
$500,001 and above $750,001 and above $391,001 and above +$91.00

Supplemental Programs

Beyond the Four Parts: Supplemental Coverage

Several programs exist outside the official A-D structure to help fill gaps or reduce costs for eligible beneficiaries. These are not official Medicare "parts" but are important parts of the overall coverage picture.

Medigap

Private insurance that covers out-of-pocket costs Original Medicare doesn't. Things like deductibles, coinsurance, and copays are included but NOT drug coverage.

Dual Eligibility & Low-Income Help

For those who qualify for both Medicare and Medicaid, or who need help with premiums and cost-sharing.

  • Original Medicare (A/B) + Medicaid
  • Medicare Savings Programs (MSPs)

Medicare Savings Programs

State programs that help pay Medicare premiums, deductibles, and coinsurance for qualifying low-income beneficiaries.

  • QMB: Qualified Medicare Beneficiary
  • SLMB: Specified Low-Income Medicare Beneficiary
  • QI: Qualifying Individual
  • QDWI: Qualified Disabled and Working Individual

Enrollment Options

How to Enroll: Three Paths

Most Medicare beneficiaries follow one of three enrollment paths. The right one depends on your healthcare needs, budget, and whether you want a single bundled plan or the flexibility of choosing parts separately.

Original Medicare (Parts A & B)

  • Enroll in Parts A & B through the federal government
  • Add a standalone Part D plan for prescriptions
  • Optionally add a Medigap plan to cover cost-sharing gaps
  • Note: Medigap does not include drug coverage

Medicare Advantage (Part C)

  • Replaces Original Medicare with a private plan
  • Includes Parts A & B, and usually Part D
  • Can add standalone Part D if plan lacks drug coverage
  • Must be enrolled in Parts A & B first

Standalone Part D

  • For those with Original Medicare who need drug coverage
  • Cannot be added if your Medicare Advantage plan already includes drug coverage
What You Cannot Do
  • You cannot have both a Medicare Advantage (Part C) plan and a Medigap policy at the same time.
  • You typically cannot purchase a standalone Part D plan if your Medicare Advantage plan already includes drug coverage.
This information is for guidance purposes only. Costs shown reflect 2026 figures sourced from the Medicare and You 2026 Handbook and Medicare Costs . We strongly recommend speaking with a licensed insurance agent before making a final decision on your Medicare plan.

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