I’m Michele Sanchez, and I run Michele Sanchez Insurance Agency in Marco Island. Medicare has four parts, and each one covers something different. Part A pays for hospital stays. Part B pays for doctor visits and outpatient care. Part C, known as Medicare Advantage, bundles A and B into a private plan. Part D covers prescription drugs.
This guide walks through what each part of Medicare covers, what it costs in 2026, and how to pick the right combination if you live in Marco Island or the greater Naples area. For a broader introduction to how the program works, our Medicare education resources cover eligibility and enrollment from the ground up.
TL;DR
- Medicare has four parts: Part A (hospital), Part B (medical), Part C (Medicare Advantage), and Part D (prescription drugs).
- Most people get Part A free. Part B costs $202.90 a month in 2026.
- Part C bundles A and B into one private plan, often with extra benefits.
- Medigap works alongside Original Medicare, not Medicare Advantage.
- I help Marco Island residents compare every option at no cost. Call (239) 682-8567.
What Are the Parts of Medicare?
Here is the full picture in one table. Use it to compare coverage and cost before you read the details below.
| Part | What It Covers | Who Runs It | 2026 Cost | When You Enroll |
|---|---|---|---|---|
| Part A | Hospital stays, skilled nursing, hospice | Federal government | $0 for most people; $1,736 deductible | Initial Enrollment Period |
| Part B | Doctor visits, outpatient care, preventive services | Federal government | $202.90/month; $283 deductible | Initial Enrollment Period |
| Part C | Bundles A and B, often adds dental, vision, hearing | Private insurers | Averages $14/month | Medicare Advantage Open Enrollment |
| Part D | Prescription drugs | Private insurers | Averages $34.50/month; $615 deductible | Annual Enrollment Period |
Medicare Part A: Hospital Insurance
Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health visits. It pays for your room, meals, nursing care, and hospital supplies during a covered stay.
Most people pay nothing for Part A. You qualify for premium-free coverage if you or your spouse paid Medicare taxes for at least 10 years. If you don’t meet that requirement, the monthly premium runs up to $565 in 2026. Everyone with Part A pays a $1,736 deductible per benefit period before coverage kicks in, according to the Centers for Medicare & Medicaid Services.
To understand exactly when to sign up for Part A, see my walkthrough of Medicare enrollment periods and important deadlines.
Medicare Part B: Medical Insurance
Part B covers the care you get outside a hospital. That includes doctor visits, lab tests, outpatient surgery, mental health services, and durable medical equipment like wheelchairs or oxygen tanks. It also pays for preventive care, including annual wellness visits and many screenings, at no extra cost.
The standard Part B premium is $202.90 a month in 2026, as confirmed by Medicare.gov. You’ll also pay a $283 annual deductible before Medicare starts covering 80 percent of approved costs. Higher earners pay more through an income adjustment called IRMAA.
Original Medicare: Parts A and B Together
When people say “Original Medicare,” they mean Part A and Part B combined. This is the traditional, government-run version of Medicare. It lets you see any doctor or hospital that accepts Medicare nationwide, but it doesn’t cap your out-of-pocket costs and doesn’t cover prescription drugs on its own.
If you want to know what Original Medicare leaves uncovered, I will walk through what Medicare does not cover in 2026 in a separate guide.
Medicare Part C: What Is Medicare Advantage?
Medicare Part C, better known as Medicare Advantage, is a private-insurance alternative to Original Medicare. Instead of getting Part A and Part B benefits directly from the government, you get them through a private insurer that Medicare approves. Most Part C plans also include Part D drug coverage and extra benefits like dental, vision, hearing aids, and gym memberships.
Part C plans average $14 a month in 2026, and some carry no premium beyond what you already pay for Part B. The trade-off is a provider network. HMO and PPO plans usually require you to use doctors in their network or pay more to go outside it. In exchange, most Part C plans cap your yearly out-of-pocket spending, which Original Medicare doesn’t do. You can explore Medicare Advantage plans in Florida to see what is available near Marco Island.
Medicare Part D: Prescription Drug Coverage
Part D pays for prescription medications through private plans that Medicare approves. Each plan uses its own formulary, a list of covered drugs sorted into pricing tiers. You can buy a standalone Part D plan alongside Original Medicare, or get drug coverage bundled into a Part C plan.
The average standalone Part D premium is $34.50 a month in 2026. The deductible can run as high as $615, depending on the plan you pick. Once your out-of-pocket drug spending hits $2,100 for the year, your plan covers 100 percent of your covered prescriptions for the rest of the year. That cap protects anyone on expensive medications from open-ended costs. I review Medicare Part D prescription drug plans with clients to match formulas to their specific medications.
Medicare Supplement Insurance (Medigap)
Medigap is optional private insurance that pays some of what Original Medicare leaves behind, including deductibles, copays, and coinsurance. It only works alongside Part A and Part B. You cannot pair Medigap with a Part C plan.
Medigap plans are labeled by letter, like Plan G or Plan N. The benefits for each letter are standardized by law, so a Plan G from one insurer covers the same things as a Plan G from any other insurer. Only the price and customer service differ. The best time to buy a Medigap policy is during your six-month Medigap Open Enrollment Period, when insurers generally cannot deny you coverage or charge you more for health conditions. I cover your Medicare supplement insurance options in detail if you want to learn more.
Which Parts of Medicare Do You Need?
The right combination depends on your health, your budget, and how you like to get care.
- Want the simplest bill and don’t mind paying a monthly premium? Original Medicare plus a Medigap plan and standalone Part D covers you nationwide with predictable costs.
- Want dental, vision, and hearing built in? A Medicare Advantage (Part C) plan often includes these at little or no added cost.
- Take several prescriptions? Compare formularies closely, since drug coverage differs a lot between Part D plans and Part C plans.
- Travel often within the U.S.? Original Medicare’s nationwide acceptance generally outperforms most Medicare Advantage networks, which are often local or regional.
If long-term care is a concern, keep in mind that none of the four parts cover custodial care. I can also walk you through long-term care insurance as a way to protect against that gap.
When Can You Enroll in the Parts of Medicare?
Missing an enrollment window can mean a late penalty that follows you for as long as you have coverage, so mark your calendar early. Here is a summary of the main windows.
| Enrollment Period | Dates | What You Can Do |
|---|---|---|
| Initial Enrollment Period | 7 months around your 65th birthday | Sign up for Part A and Part B |
| General Enrollment Period | January 1 to March 31 | Enroll if you missed your initial window; late penalties may apply |
| Medicare Advantage Open Enrollment | January 1 to March 31 | Switch or drop a Part C plan |
| Annual Enrollment Period | October 15 to December 7 | Change Part C or Part D coverage for the following year |
For a full timeline with exact deadlines, see my guide to when to sign up for Medicare. If you are ready to act, my step-by-step walkthrough of how to enroll in Medicare in Florida covers the full process.
Medicare Help in Marco Island, FL
Choosing between Original Medicare, Medicare Advantage, and a Medigap policy gets easier with local guidance. I work with Marco Island and Collier County residents to compare real plan options side by side, including which local doctors and hospitals each network covers.
There is no cost for a consultation, and there is no obligation to enroll through my agency. You can also visit our Medicare Advantage plans page to see the options available in your area.
Frequently Asked Questions About the Parts of Medicare
What Is Part C of Medicare?
Part C, or Medicare Advantage, is a private insurance plan that bundles Part A and Part B benefits, and usually Part D, into one plan. Many Part C plans add dental, vision, and hearing coverage. You enroll through a private insurer that Medicare approves, and your coverage replaces Original Medicare rather than adding to it.
Do I Need Part D If I Have a Medicare Advantage Plan?
Not separately. Most Medicare Advantage plans already include Part D drug coverage. Buying a standalone Part D plan on top of a Medicare Advantage plan usually is not allowed and can trigger disenrollment from your Part C plan. If your Part C plan does not include drug coverage, you may be able to add a standalone plan in certain situations.
What Is the Difference Between Medicare Parts A, B, C, and D?
Part A covers inpatient hospital care. Part B covers outpatient medical care like doctor visits and lab work. Part C is a private-plan bundle of both, usually with drug coverage added. Part D is a standalone prescription drug plan. Together, Parts A and B form Original Medicare, while Part C is an alternative that replaces them.
Is Original Medicare Free?
Part A is premium-free for most people who or whose spouse paid Medicare taxes for at least 10 years. Part B carries a monthly premium of $202.90 in 2026. Neither part is entirely free once you factor in deductibles and coinsurance. Higher earners also pay more for Part B and Part D through income-related adjustments called IRMAA.
Can I Have Both Medicare Advantage and a Medigap Plan?
No. Medigap only works with Original Medicare (Parts A and B). If you are enrolled in a Part C plan, you generally cannot also use a Medigap policy to cover your cost-sharing. If you are considering switching from Medicare Advantage back to Original Medicare, talk to me first about your Medigap options and any health-underwriting rules that may apply.
What Does Medicare Not Cover Across All Four Parts?
Original Medicare generally does not cover routine dental, vision, hearing, or long-term custodial care. Part C plans may add dental, vision, and hearing benefits, but long-term care is not covered by any Medicare part. I have a full breakdown of what Medicare does not cover in 2026 if you want to review the gaps before you choose a plan.
How Do I Choose Between Original Medicare and Medicare Advantage in Marco Island?
The choice comes down to your doctors, prescriptions, travel habits, and budget. Original Medicare gives you nationwide provider access with predictable cost-sharing when you add Medigap. Medicare Advantage often has lower monthly premiums and bundled extras, but limits you to a local network. I compare both options side by side with Marco Island and Naples residents at no cost.
The Bottom Line on the Parts of Medicare
Understanding the parts of Medicare comes down to four choices: hospital coverage, medical coverage, a private bundle of both, and drug coverage. How you combine them shapes your monthly premium, your provider network, and your out-of-pocket risk. The enrollment windows are firm, and missing one can mean a lasting penalty, so the earlier you start comparing, the better.
If you’re looking for a local, no-cost second opinion on which Medicare coverage combination may fit your needs in Marco Island, call (239) 682-8567 or visit my Medicare Education Center to explore more helpful guides. I’m happy to walk you through your options, answer your questions, and help you understand your choices before your enrollment window closes. Contact Michele Sanchez today for personalized Medicare guidance at no cost.
Warmly, Michele Sanchez…
