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Medicare Explained: Parts A, B, C and D in Plain English
Parts A, B, C and D explained in plain words for Florida. Call or text 813-302-7151.
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Medicare has several parts, but you do not buy all of them as four separate policies. Parts A and B form the starting point. Then you decide how to receive those benefits and how to handle prescription coverage.
A more useful question than ‘Which part do I need?’ is ‘How will my doctors, medicines and other insurance work together?’
Part A and Part B (Original Medicare)
Part A covers inpatient hospital care and certain other services, such as eligible skilled nursing and hospice care. Part B covers doctor visits, outpatient care, preventive care and some medical equipment. Each service has to meet Medicare’s rules to be covered.
With Original Medicare you can see any provider that accepts Medicare. You still pay deductibles and coinsurance, and Original Medicare by itself has no yearly limit on what you spend out of pocket.
Here are the main 2026 amounts from the CMS 2026 Medicare Parts A and B fact sheet. The 2027 amounts have not been announced yet; we update this page when the new figures are published.
| 2026 | Part A (hospital) | Part B (medical) |
|---|---|---|
| Monthly premium | $0 for most people. If you buy Part A: $311 with 30 to 39 quarters of Medicare-covered work, $565 with fewer than 30 quarters | $202.90 standard premium (people with higher incomes pay more) |
| Deductible | $1,736 per benefit period | $283 a year |
If your income is higher, see why Medicare premiums go up for the 2026 income brackets.
Part C: Medicare Advantage
Medicare Advantage is another way to get your Part A and Part B benefits, through a private plan approved by Medicare. Most plans include drug coverage. Networks, referrals, prior authorization and copays can be different from Original Medicare. You need both Part A and Part B to join, and you generally keep paying your Part B premium. Before you join, check the plan’s yearly limit on medical costs and whether your doctors are in its network.
Part D: prescription drug coverage
Part D helps pay for prescription drugs you fill at a pharmacy. You can get it as a standalone plan with Original Medicare, or inside many Advantage plans. Each plan has its own drug list (formulary), pharmacy network and rules. In 2026 no drug plan may have a deductible above $615, and once your out-of-pocket costs for covered drugs reach $2,100 you pay nothing more for them that year. For 2027 those limits are $700 and $2,400 (Medicare.gov: Part D costs).
Do not add a standalone drug plan to an Advantage HMO or PPO without checking first. It can end your Advantage enrollment.
Medicare Supplement (Medigap)
Medigap is extra coverage used with Original Medicare to help with certain out-of-pocket costs. It is different from Medicare Advantage and does not work with an Advantage plan. Covered by Guzman does not sell Medigap. For questions about Medigap enrollment rights or availability, use Medicare’s official information or Florida SHINE. We explain it here so you can tell it apart from Advantage.
Enrollment periods: when you can sign up or switch
Initial Enrollment Period. When you first become eligible at 65, you have seven months to sign up: it starts 3 months before the month you turn 65 and ends 3 months after it.
Open Enrollment, October 15 to December 7. Every fall you can join, switch or drop a Medicare Advantage plan or a drug plan. Changes start January 1.
Medicare Advantage Open Enrollment, January 1 to March 31. This is only for people already in an Advantage plan. You can switch to another Advantage plan, or go back to Original Medicare and join a separate drug plan.
Moving, losing certain coverage and other situations can open a Special Enrollment Period. Signing up for Part B and changing a private plan follow different rules.
Help paying: Extra Help and Medicare Savings Programs
Extra Help lowers Part D costs such as premiums, deductibles and copays. Medicare Savings Programs can pay the Part B premium and, in some cases, other Medicare costs. Each program has its own income and resource limits, and the program decides who qualifies. Our Extra Help and Medicare Savings Programs guide lists the 2026 limits. An Advantage plan’s allowance or giveback is not a substitute for these programs.
Talk to a licensed Medicare agent by phone
For a phone or video review, have your Medicare card, other insurance details, county, doctors and current prescriptions ready. Tell us about work coverage or VA benefits before changing anything. Covered by Guzman helps with Advantage and Part D choices and stays available for service questions after enrollment. You can also compare plans directly on Medicare.gov.
Official resources: Medicare.gov: Medicare costs; Medicare.gov: joining a plan; Medicare.gov: what drug plans cover; Florida SHINE (free Medicare counseling).
We do not offer every plan available in your area. For information on all of your options, please contact Medicare.gov, call 1-800-MEDICARE, or contact your local State Health Insurance Assistance Program (SHIP).
Frequently Asked Questions
What does Medicare cover?
Part A covers inpatient hospital care and certain skilled nursing and hospice care. Part B covers doctor visits, outpatient care, preventive care and some medical equipment. Drug coverage comes from Part D or from an Advantage plan that includes it.
What is the difference between Medicare and Medicaid?
Medicare is federal health insurance based mainly on age 65 or a qualifying disability. Medicaid is a joint federal and state program based on income and other state rules. Some people qualify for both.
Does Medicare cover dental and vision?
Original Medicare generally does not cover routine dental care or routine eye exams and glasses, with a few medical exceptions. Many Medicare Advantage plans add dental and vision benefits, so check each plan’s limits.
When can I change my Medicare plan?
Most people change plans during Open Enrollment, October 15 to December 7. If you are in an Advantage plan, you can also switch from January 1 to March 31, and events such as a move can open a Special Enrollment Period.
Is Medicare free?
No. Most people pay no premium for Part A, but in 2026 the standard Part B premium is $202.90 a month and the Part B deductible is $283. Advantage and drug plans can add their own premiums and copays.
Do I need Part D if I don’t take medications?
It is usually worth having Part D or other creditable drug coverage even if you take no medicines today. Going without it can add a late enrollment penalty later and leave future prescriptions uninsured.
What happens if I don’t sign up for Medicare on time?
You may pay a late enrollment penalty and have a gap in coverage, unless an exception applies, such as coverage from a current job. Check your employer coverage and your enrollment rights before you delay.
Can I get Medicare help in Spanish?
Yes. Covered by Guzman offers Spanish-language service, and Medicare provides Spanish resources and telephone assistance.
This guide is general information, not legal, tax or medical advice. Your plan documents, including the Summary of Benefits and Evidence of Coverage, control what is covered and what you pay.
About the Author
Raymundo Guzman
I am Raymundo Guzman, a licensed independent insurance agent and the owner of Covered by Guzman. On the health side, I help Florida individuals, families and small businesses compare ACA Marketplace plans, Medicare Advantage and Part D, and dental and vision coverage, checking doctors and medications before anything is submitted. I work in English and Spanish, and a member of our team speaks Arabic. We usually meet by phone or video, and I stay available after enrollment.
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