Skip to main content

Overview of the Four Parts of Medicare


If you recently had a medical procedure or were hospitalized, you may be confused about a recent bill and are wondering what Medicare will cover, what your gap insurance will cover, and what you will be responsible for. It may help to have a better understanding of the four main parts of Medicare.

Part A helps pay for inpatient stays in hospitals and skilled nursing facilities, some home care and end-of-life hospice care that accept Medicare. Hospital services covered include a semi-private room and meals, general nursing, drugs and supplies, inpatient rehabilitation, and some blood transfusions. Skilled nursing services include care for things like recovering from hip replacement surgery or stroke. Part A charges a deductible for hospital stays (the fee for 2025 is $1,676) but your Medigap insurance may cover that expense. Hospital stays for up to 60 days and virtually most services are covered by Medicare; but the one exception is not in a private room.

Part B covers doctors and outpatient services, and together with part A make up what is considered “Original Medicare.” Part B pays for diagnostic screenings, lab tests, preventive services, some medical equipment and transportation. It covers doctor visits and other outpatient services. There is a monthly premium with Part B, and in 2025 it is $185. For those making over $106,000 annually it may be higher. Part B only pays a portion of covered expenses and Medigap insurance policies are designed to cover some or all the difference depending on the plan.

Part C is what Medicare Advantage comes under, and is privately held insurance rather than Medicare, which is run by the federal government. If you choose Medicare Advantage, you will still need to sign up for Medicare part A and B and usually pay the premium for part B. Medicare Advantage plans set their own deductibles and you typically need to stay in a Network and use your plan’s approved providers or pay higher out of pocket costs.

Part D is again from a private insurer and pays for some of your prescription drugs. Generally there is a co-pay for each prescription, and you may have a premium, and a yearly deductible. Check with Medicare regarding rules for higher yearly drug costs and your responsibility.

Remember Medicare offers an open enrollment period each year to allow recipients to make changes to their plan. The period starts on October 15 and ends December 7. Any changes you make during this time will go into effect the following year.

At MorningStar at River Oaks, our 55+ community offers luxury assisted living with a variety of floor plans, onsite amenities, wellness programs and activities. For seniors with Alzheimer’s and other dementia-related diseases, our distinct Reflections Neighborhood provides specialized care. Visit our website to see what sets our community apart from other senior living in Houston and why MorningStar is a great place to call home.

MorningStar has considered it a privilege and responsibility to “cast a new light” on senior living, inspired and empowered by our unique mission: to honor, to value, to invest. Our passionate commitment to serving seniors has proudly earned us a reputation for satisfaction that is second to none. Contact us to learn more about the finest senior living apartments Houston has to offer.

Comments

Popular posts from this blog

The Role of Sleep in Managing Chronic Pain for Elderly Patients

Sleep plays a critical role in the management of chronic pain, especially among the elderly. At facilities like senior housing Kirkland and senior living Kirkland , understanding and addressing the interplay between sleep and pain is key to improving residents' quality of life. Impact of Sleep on Pain Perception Research shows that poor sleep can increase sensitivity to pain. This is particularly relevant for seniors, as they are more likely to suffer from both sleep disturbances and chronic pain conditions. Good sleep helps to restore the body's natural pain control mechanisms, making it an essential element of pain management strategies. Strategies for Improving Sleep in Elderly Patients To enhance sleep quality and manage pain effectively, several strategies can be implemented. First, establishing a regular sleep schedule helps to regulate the body's internal clock and improve sleep quality. It's also important to create a sleep-conducive environment—quiet, dark, and...

The Risks of Undetected SMIs

  Did you know 45% of heart attacks are a “silent myocardial infarction (SMI)” and are likely to go undetected? Expert says they are more common in men than women, and a person typically does not experience the intensity felt during a normal heart attack. Often it is mistaken for heartburn, indigestion and other age-related aches and pains.     A study published a few years ago in the Journal of the American Medical Association , found evidence of men suffering from undetected mild heart attacks. The study involved almost 2,000 people ages 45 to 84 (half of whom were men) who were free of any signs of cardiovascular disease. When doctors examined the group after ten years, “8% had myocardial scars, which are evidence of a heart attack. Most surprising was that 80% of these people were unaware of their condition.” The presence of myocardial scars was five times higher in men than in women. While symptoms can be mild and brief, experts say to seek immediate medic...

Considering Moving from Your Own Home into Senior Housing?

If you are moving from your own home into an independent living community or another type of senior housing, most likely you will want to downsize. While it can sound overwhelming to go through a whole household of stuff and whittle it down to fit into a modest sized apartment, a few tips will help. In the end, it comes down to deciding what to bring with you and what to leave behind.  Without question it is a lot of work and can be stressful and emotional but the Internet offers lots of useful information from organizing experts . Most say the trick is to prepare in advance by making a plan and allowing plenty of time. Remember if you need, there are companies who offer these services and will do everything from helping with the downsizing process to packing up, and moving your things to your new home.  Now you are ready for the sorting out process deciding what you will bring and what to give to family, donate, or throw away. This is the hardest task as your house is full o...