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Medicare is split into four parts, each covering something different and each with its own costs. Here's a clear breakdown of Part A, B, C, and D — what's covered, what it costs in 2026, and where to go for official answers.
Medicare is the federal health insurance program for people 65 and older, and for some younger people with certain disabilities or conditions. Rather than one single plan, it's built from four distinct parts — Original Medicare (Parts A and B), private Medicare Advantage plans (Part C), and prescription drug coverage (Part D). Understanding what each one covers, and what it costs, is the first step to choosing the right combination for your situation.
The figures below reflect 2026 Medicare amounts. They're a helpful starting point, not a substitute for your official plan documents — for the definitive, up-to-date numbers, always confirm at Medicare.gov.
Part A covers care you receive as an inpatient, along with a handful of related services. Most people don't pay a monthly premium for it, since it's typically funded through payroll taxes paid during their working years.
Part B covers the care you receive as an outpatient — doctor visits, preventive screenings, and the equipment and services that keep you out of the hospital in the first place. Unlike Part A, nearly everyone pays a monthly premium for it.
Medicare Advantage plans are sold by private insurance companies approved by Medicare. Instead of Original Medicare paying your claims directly, your chosen plan does — and by law, it must cover at least everything Original Medicare covers.
Part D helps pay for prescription medications, through plans offered by private insurers. It's either a standalone plan added to Original Medicare, or bundled into a Medicare Advantage plan.
One of the biggest decisions in Medicare is choosing between Original Medicare (A + B, often with a Part D and/or Medigap policy added) and a Medicare Advantage plan (Part C). Here's how they differ at a glance.
| Original Medicare (A + B) | Medicare Advantage (Part C) | |
|---|---|---|
| Who pays claims | Medicare, directly | Your private plan |
| Provider choice | Any provider nationwide that accepts Medicare | Typically a defined network (HMO/PPO) |
| Annual out-of-pocket cap | None — costs can be unlimited without added coverage | Yes, required by law |
| Drug coverage | Requires a separate Part D plan | Usually bundled in |
| Extra benefits | Not included | Often includes dental, vision, hearing |
| Supplement option | Can add a Medigap policy to cover gaps | Medigap not compatible with Advantage plans |
Timing matters — enrolling late in Part B or Part D without other creditable coverage can mean a permanent penalty added to your premium.
A 7-month window centered on your 65th birthday — 3 months before, your birthday month, and 3 months after.
If you're still covered by an employer group plan when you turn 65, you can generally delay enrolling without penalty until that coverage ends.
October 15 – December 7 each year. This is your window to switch Medicare Advantage or Part D plans for the following year.
January 1 – March 31. If you're already in a Medicare Advantage plan, this is a second chance to switch plans or move back to Original Medicare.
For the definitive word on coverage, costs, and your specific situation, these are the official U.S. government sources — not a private insurance site.
Medicare rules apply the same way to everyone, but the right plan rarely looks the same for any two people. GIC Insurance Consultants can walk through your coverage options with you at no cost, based on your medications, doctors, and budget.
Contact GIC Insurance Consultants