Medicare Plans

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Medicare 101

What is Medicare?

Medicare is a federal health insurance program primarily for people age 65 and older, as well as people with certain disabilities or chronic health conditions. It helps cover hospital stays, medical services, & prescription drugs — playing a critical role in keeping care affordable in retirement.

Who can receive Medicare?

Medicare is available to U.S. citizens & permanent residents who meet these criteria:

Age 65 or older — most people qualify when they turn 65.
Younger than 65 with a disability — if you have a qualifying disability or a specific condition like end-stage renal disease (ESRD), you may be eligible before 65.

Not Enrolled in Medicare Yet?

The four parts of Medicare

Medicare is structured into four main sections — A, B, C, & D — that together cover hospital care, outpatient services, private plan options, & prescription drugs.

Medicare Part A

Hospital Insurance

Medicare Part A covers inpatient care per benefit period — hospital stays, skilled nursing facility care after a qualifying stay, hospice, & home health services. Most people qualify premium-free at 65 based on their (or a spouse's) work history.

Semi-private room, meals, & drugs during inpatient stay
Skilled nursing facility care after a qualifying hospital stay
Hospice care & part-time home health services
Inpatient or outpatient rehab after a qualified stay
First 3 pints of blood & some transfusions

2026 deductible: $1,736
Days 1–60: $0 after deductible
Days 61–90: $434 / day
Days 91–150 (lifetime reserve): $868 / day
SNF days 21–100: $217 / day

Medicare Part B

Medical Insurance

Medicare Part B covers doctor visits & outpatient care per calendar year — including preventive services, lab work, imaging, therapy, mental health care, & durable medical equipment used at home.

Doctor visits (including while hospitalized) & preventive care
Clinical labs, X-rays, MRIs, CT scans, EKGs
Physical, occupational, & speech-language therapy
Durable medical equipment: oxygen, CPAP, wheelchairs, walkers
Mental & behavioral health, ambulance, ER services

2026 monthly premium: $202.90
Annual deductible: $283
You pay after deductible: 20% of approved amount
Clinical lab services: Generally $0

Medicare Part C

Medicare Advantage

Medicare Advantage plans are private, Medicare-approved HMO or PPO plans that bundle Parts A & B — & usually Part D — into a single plan. Many include extra benefits Original Medicare doesn't cover.

Combines Parts A, B, & (usually) D in one plan
Covers PCP, specialist, hospital, emergency & urgent care, imaging/labs
Extras many plans add: dental, vision, hearing, transportation, OTC card, food or utility card, fitness membership, give-back
You cannot use or be sold a Medigap policy while enrolled

Must have: Medicare Part A & B
Part B premium still applies: $202.90 / month
Network type: HMO or PPO

Medicare Part D

Prescription Drug Coverage

Medicare Part D adds prescription drug coverage to Original Medicare, or is bundled into most Medicare Advantage plans. The 2026 standard benefit moves through three stages each calendar year.

Stage 1 — Deductible: up to $615 (some plans $0; some waive Tiers 1–2)
Stage 2 — Initial coverage: up to 25% coinsurance until $2,100 out-of-pocket max
Stage 3 — Catastrophic coverage: $0 cost-sharing for covered Part D drugs
All amounts reset every January 1

Max plan deductible: $615
Out-of-pocket max threshold: $2,100
Catastrophic cost-sharing: $0
2026 national base premium: $38.99

For educational purposes only. Alliance Global Insurance Group is not affiliated with or endorsed by Medicare.gov or the U.S. government. For official Medicare information, visit Medicare.gov or call 1-800-MEDICARE.

Side-by-side

Medicare Plan Comparison

A quick, plain-language look at how each part of Medicare stacks up so you can see the differences at a glance.

Feature	Part AHospital	Part BMedical	Part CAdvantage	Part DDrug
What it covers	Inpatient hospital, skilled nursing, hospice, some home health	Doctor visits, outpatient care, preventive services, durable medical equipment	All of Part A + Part B (often with Part D & extras) in one plan	Prescription drug coverage
Offered by	Federal government (Original Medicare)	Federal government (Original Medicare)	Private, Medicare-approved insurers	Private, Medicare-approved insurers
Provider access	Any provider nationwide that accepts Medicare	Any provider nationwide that accepts Medicare	Plan network (HMO/PPO); referrals may be required	Plan's pharmacy network
Prescription drugs	Limited (drugs given during inpatient stays)	Limited (some infused/injected drugs at the doctor)	Usually included (MAPD plans)	Yes — outpatient prescriptions
Dental, vision, hearing extras	Not covered	Not covered	Many plans include some extras (varies by plan)	Not covered
Out-of-pocket maximum	No annual cap on its own	No annual cap on its own	Yes — annual in-network out-of-pocket max	Yes — Part D annual cap on covered drug costs
Works with Medigap?	Yes — Medigap pairs with Original Medicare	Yes — Medigap pairs with Original Medicare	No — you can't use Medigap with a Medicare Advantage plan	Yes — pairs with Original Medicare (with or without Medigap)
Typical monthly premium	$0 for most people (based on work history)	Standard Part B premium set by CMS each year	Varies; many plans have low or $0 premium (Part B premium still applies)	Varies by plan & drug list
Best for	Foundational hospital coverage for almost everyone on Medicare	Foundational outpatient/doctor coverage for almost everyone on Medicare	People who want an all-in-one plan with extras & a lower premium	People on Original Medicare who need prescription drug coverage

Part A

Hospital

What it covers: Inpatient hospital, skilled nursing, hospice, some home health
Offered by: Federal government (Original Medicare)
Provider access: Any provider nationwide that accepts Medicare
Prescription drugs: Limited (drugs given during inpatient stays)
Dental, vision, hearing extras: Not covered
Out-of-pocket maximum: No annual cap on its own
Works with Medigap?: Yes — Medigap pairs with Original Medicare
Typical monthly premium: $0 for most people (based on work history)
Best for: Foundational hospital coverage for almost everyone on Medicare

Part B

Medical

What it covers: Doctor visits, outpatient care, preventive services, durable medical equipment
Offered by: Federal government (Original Medicare)
Provider access: Any provider nationwide that accepts Medicare
Prescription drugs: Limited (some infused/injected drugs at the doctor)
Dental, vision, hearing extras: Not covered
Out-of-pocket maximum: No annual cap on its own
Works with Medigap?: Yes — Medigap pairs with Original Medicare
Typical monthly premium: Standard Part B premium set by CMS each year
Best for: Foundational outpatient/doctor coverage for almost everyone on Medicare

Part C

Advantage

What it covers: All of Part A + Part B (often with Part D & extras) in one plan
Offered by: Private, Medicare-approved insurers
Provider access: Plan network (HMO/PPO); referrals may be required
Prescription drugs: Usually included (MAPD plans)
Dental, vision, hearing extras: Many plans include some extras (varies by plan)
Out-of-pocket maximum: Yes — annual in-network out-of-pocket max
Works with Medigap?: No — you can't use Medigap with a Medicare Advantage plan
Typical monthly premium: Varies; many plans have low or $0 premium (Part B premium still applies)
Best for: People who want an all-in-one plan with extras & a lower premium

Part D

Drug

What it covers: Prescription drug coverage
Offered by: Private, Medicare-approved insurers
Provider access: Plan's pharmacy network
Prescription drugs: Yes — outpatient prescriptions
Dental, vision, hearing extras: Not covered
Out-of-pocket maximum: Yes — Part D annual cap on covered drug costs
Works with Medigap?: Yes — pairs with Original Medicare (with or without Medigap)
Typical monthly premium: Varies by plan & drug list
Best for: People on Original Medicare who need prescription drug coverage

Learn about Medicare Advantage Learn about Medigap Learn about Part D

Educational comparison only. Specific plan benefits, networks, & costs vary by carrier, plan year, & ZIP code. Talk to a licensed Medicare advisor for details on plans in your area.

The origins of Medicare

Medicare is a vital federal health insurance program that has significantly shaped the U.S. healthcare landscape. Launched in 1965 under President Lyndon B. Johnson, it was designed to address the lack of affordable healthcare options for seniors, who often struggled to obtain private coverage. Today it remains one of the most important pillars of retirement security in America.