What are Medicare Parts A, B, C, and D?
Part A covers hospital stays, skilled nursing, hospice, and some home health. Part B covers doctor visits, outpatient care, and preventive services. Part C, also called Medicare Advantage, is an all-in-one private plan that bundles A and B (and usually D). Part D covers prescription drugs. Most Washington residents enroll during the 7-month enrollment window around their 65th birthday.
What does Original Medicare cover?
Original Medicare (Parts A and B) covers most hospital and doctor care across the country. It pays roughly 80% of approved charges. You pay the rest — deductibles, copays, and coinsurance — unless you have a supplement plan filling that gap.
What does Original Medicare NOT cover?
Original Medicare does not cover routine dental, vision exams, hearing aids, or long-term custodial care. It also doesn't cover prescription drugs — that's Part D. Most people add a Medicare Supplement (with a Part D plan) or choose a Medicare Advantage plan to fill these gaps. Learn more about Medicare Supplement vs Medicare Advantage in Washington and whether Medicare covers long-term care in Washington.
How is Medicare different in Washington State?
The federal rules are the same nationwide, but Washington has its own mix of carriers, networks, and Medicare Advantage plans. What's available in Pierce County may differ from King or Thurston County. Provider networks for Advantage plans are local — your doctor in Tacoma may not be in the same network as a clinic in Olympia.
A note for veterans and military families in Pierce County
If you or your spouse are TRICARE beneficiaries transitioning out of military service, Medicare interacts with TRICARE differently than it does with civilian employer coverage. Understanding how TRICARE for Life works alongside Medicare Parts A and B is one of the most underserved topics for veterans in the Pierce County and Joint Base Lewis-McChord area.
If this applies to you, it's worth a specific conversation — the standard Medicare information most people find online doesn't address the TRICARE intersection.
How much does Medicare cost?
In 2026, the standard Part B premium is $202.90/month. Most people pay $0 for Part A because they paid Medicare taxes through work for 10+ years. A Medicare Supplement plan in Washington typically runs $230–$350/month depending on age, plan letter, and carrier. Part D drug plans run about $20–$60/month. Some Medicare Advantage plans in Washington have $0 monthly premiums but may have copays and network rules. For a full breakdown, see how much Medicare costs in Washington.
The four parts at a glance
| Part | What it covers | Who needs it |
|---|---|---|
| Part A | Hospital stays, skilled nursing, hospice | Almost everyone — usually $0/month |
| Part B | Doctor visits, outpatient care, preventive services | Most people enrolling in Medicare |
| Part C | Medicare Advantage — all-in-one plan from a private carrier | People who want a bundled, network-based plan |
| Part D | Prescription drug coverage | Anyone who takes prescriptions or wants to avoid the late penalty |
Frequently asked questions
This is one of the most confusing transitions in adult life. Most people have the same questions — most people don't have clear answers until they sit down with someone who actually works with this every day.
Do I need both Part A and Part B?
Can I keep my doctor on Medicare in Washington?
What's the difference between Medicare Supplement and Medicare Advantage?
Does Medicare cover prescriptions?
One thing Medicare doesn't cover that Washington residents often miss
Medicare does not cover long-term custodial care — nursing homes, assisted living, or ongoing in-home help with daily activities. This surprises most people, and it's one of the most expensive surprises in retirement.
For Western Washington residents, the gap beyond Medicare's 100 days is addressed in the long-term care planning section of this site.
Washington is the first state in the country to address this through the WA Cares Fund, a lifetime benefit of up to $36,500 for eligible residents, beginning July 1, 2026. At Washington's nursing home rates of over $13,000 per month, that covers approximately two to three months. It's a starting point, not a complete solution.
Understanding where Medicare ends and long-term care planning begins is one of the most important retirement conversations Washington residents can have.
Learn more: Does Medicare cover long-term care in Washington? →
What Medicare Doesn't Cover
Understanding the Gaps Is as Important as Understanding the Coverage
Medicare covers a wide range of medical costs. It does not cover long-term custodial care, routine dental, vision, or hearing, and it does not protect the household income your spouse depends on if you die. Knowing where Medicare ends is where the rest of retirement planning begins.
Want help making sense of it?
As a licensed Medicare advisor serving Washington State, I'll walk you through the four parts and how they fit your life — in clear terms.
There's no charge to talk and no obligation to decide. If it's not the right fit, I'll tell you that too.