The short version: four parts, two paths

Medicare is built out of four "parts," and once you see how they fit together the whole system gets a lot less confusing. Two of the parts — Part A and Part B — make up what's called Original Medicare, the coverage run directly by the federal government. The other two — Part C (Medicare Advantage) and Part D (prescription drugs) — are offered by private, Medicare-approved insurance companies and are how you customize your coverage.

Here in Charlotte and across North Carolina, most people approaching 65 end up choosing between two paths: keep Original Medicare (Parts A and B) and add a stand-alone Part D drug plan — often alongside a Medicare Supplement (Medigap) policy — or get a Medicare Advantage plan (Part C) that bundles it together. Understanding the four parts first is what makes that decision clear.

Part A — Hospital Insurance

Part A is the "hospital" side of Original Medicare. It covers care you receive as an admitted inpatient and in certain institutional settings:

  • Inpatient hospital care — your room, general nursing, meals, and hospital services once a doctor formally admits you. (Watch for the "observation" trap: being kept under observation is billed as outpatient under Part B, not Part A — it's worth asking about your admission status.)
  • Skilled nursing facility (SNF) care — but only after a qualifying inpatient hospital stay of at least 3 days in a row, and only for skilled care like IV therapy or rehab. Medicare covers up to 100 days per benefit period when you stay eligible.
  • Hospice care for someone certified as terminally ill who chooses comfort care.
  • Some home health care — skilled, part-time care when a doctor certifies you're homebound.

Most people pay $0 per month for Part A in 2026 because they (or a spouse) worked and paid Medicare taxes for at least 40 quarters (about 10 years). If you have 30–39 quarters, the Part A premium is $311/month in 2026; with fewer than 30 quarters it's $565/month in 2026. When you're admitted, the Part A inpatient hospital deductible is $1,736 per benefit period in 2026.

Part B — Medical Insurance

Part B is the "outpatient and doctor" side of Original Medicare. It covers:

  • Doctor visits, specialist care, and outpatient hospital care
  • Preventive services — many at no cost when you use a provider who accepts assignment, including the annual "Wellness" visit and many screenings
  • Durable medical equipment (wheelchairs, walkers, oxygen, blood-sugar monitors)
  • Lab tests, outpatient surgery, ambulance services, and outpatient therapy

In 2026, the standard Part B premium is $202.90 per month and the annual Part B deductible is $283. After you meet that deductible, you generally pay 20% of the Medicare-approved amount for most Part B services. Important point: Original Medicare has no annual out-of-pocket cap on Parts A and B — that 20% keeps going with no ceiling, which is a big reason many people add a Medigap policy or choose Medicare Advantage.

Higher earners pay more for Part B through an add-on called IRMAA. In 2026 it begins above a modified adjusted gross income of $109,000 for an individual or $218,000 for a married couple filing jointly, using your income from two years prior (2026 looks at your 2024 return). The first bracket adds $284.10 to Part B and $14.50 to Part D per month.

Part C — Medicare Advantage

Part C, better known as Medicare Advantage, is a private plan that bundles Part A and Part B into one plan — and usually adds more. These plans are offered by Medicare-approved insurers and are an alternative to Original Medicare, not an add-on to it.

  • Bundled drug coverage: Most Medicare Advantage plans include Part D prescription coverage in the same plan (these are called MA-PD plans).
  • Extra benefits: Many include things Original Medicare doesn't — commonly routine dental, vision, hearing, and fitness memberships. These extras vary widely by plan, carrier, and location, and aren't guaranteed, so it's worth verifying the specific plan.
  • An out-of-pocket maximum: Every Medicare Advantage plan is required to cap your yearly out-of-pocket costs for Part A and B services — a key structural difference from Original Medicare, which has no cap.
  • Networks: Many plans use provider networks. HMO plans generally require you to stay in-network and get referrals; PPO plans let you go out-of-network but usually at a higher cost. If you have specific Charlotte-area doctors, confirm they're in the plan's network before enrolling.

One thing to know: you can't pair Medicare Advantage with a Medigap policy — Medigap only works with Original Medicare.

Part D — Prescription Drug Coverage

Part D covers outpatient prescription drugs — the medicines you take at home. This matters because Original Medicare (Parts A and B) does not cover most of those drugs, so Part D fills that gap. You can get it as a stand-alone plan alongside Original Medicare, or built into most Medicare Advantage plans.

Each Part D plan has a formulary (its list of covered drugs) and places those drugs on cost tiers, so the same medication can cost very differently from one plan to the next. In 2026, once your out-of-pocket drug spending reaches $2,100, you reach the catastrophic phase and pay $0 for covered drugs for the rest of the year. Because formularies change and your medications change over time, this is exactly the kind of coverage worth reviewing every year.

Watch the enrollment windows and penalties

The parts also come with timing rules that carry real financial consequences:

  • Your Initial Enrollment Period is a 7-month window around your 65th birthday — the 3 months before, your birth month, and the 3 months after.
  • The Part B late penalty is 10% for each full 12 months you could have had Part B but didn't — and it lasts for life.
  • The Part D late penalty is 1% of the national base beneficiary premium per month you go without creditable drug coverage.
  • Medigap Open Enrollment is a one-time 6-month window from your Part B effective date, when you can buy a Medigap policy with guaranteed issue and no health questions.
  • The Annual Enrollment Period (Oct 15–Dec 7) is when you can join, switch, or drop Medicare Advantage and Part D plans for the coming year.

Some of these windows — like your Initial Enrollment Period and your one-time Medigap Open Enrollment — only come around once, while others like the Annual Enrollment Period repeat each year, so it helps to know which is which before you turn 65.

How The Jordan Insurance Agency helps

Sorting Parts A, B, C, and D into the right combination for your doctors, medications, and budget is where guidance pays off. The Jordan Insurance Agency is an independent, full-time, licensed and certified agency based in Charlotte, North Carolina, serving people across the state. As an experienced independent agent, we represent multiple carriers, complete our annual AHIP and carrier certifications, carry E&O coverage, and review your plan every year at renewal — so your drug list, network, and costs are re-checked as things change. We use real enrollment technology to compare your actual prescriptions and providers across plans, and we explain the honest trade-offs without pressure. Best of all, our help costs you nothing extra: the carrier pays the agent, and your premium is the same whether you enroll on your own or with us. For anything specific to your situation, we'll always point you to the current figures on Medicare.gov or 1-800-MEDICARE — and then walk through them with you.

Plan availability & disclaimer

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. The Jordan Insurance Agency is not connected with or endorsed by the United States government or the federal Medicare program.