Coverage Options Under Medicare

Original Medicare

Original Medicare includes Part A (Hospital Insurance) and Part B (Medical Insurance).

Part A (Hospital Insurance)

  • Covers: Inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
  • Costs: Most people don't pay a monthly premium for Part A if they or their spouse paid Medicare taxes for a certain amount of time while working.

Part B (Medical Insurance)

  • Covers: Doctor's services, outpatient care, medical supplies, and preventive services.
  • Costs: Most people pay a monthly premium for Part B. The standard premium amount can change each year.

Medicare Advantage (Part C)

Medicare Advantage Plans are offered by private companies approved by Medicare. They combine Part A and Part B, and usually Part D (prescription drug coverage).

  • How it Works: These plans provide all of your Part A and Part B benefits, and many offer extra benefits like vision, hearing, and dental.
  • Types of Plans: Common types include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) Plans, and Special Needs Plans (SNPs).
  • Costs: You continue to pay your Part B premium, and you may pay an additional premium to your Medicare Advantage Plan.

Link placeholder to more information about choosing a Medicare Advantage plan: CHOOSING MEDICARE ADVANTAGE PLAN

Supplemental (Medigap) Insurance

Medigap policies are sold by private companies and can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.

  • How it Works: You must have Original Medicare (Part A and Part B) to buy a Medigap policy.
  • Coverage: Medigap policies only work with Original Medicare; they don't work with Medicare Advantage Plans.
  • Standardization: Medigap policies are standardized, meaning each plan letter (e.g., Plan G, Plan N) offers the same basic benefits, regardless of the insurance company.

Link placeholder to more information about choosing Medigap / supplemental plans: CHOOSING MEDICARE SUPPLEMENTAL PLANS