Understanding Medicare plan options

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

You can join a separate Medicare drug plan to get Medicare drug coverage (Part D).

You can use any doctor or hospital that takes Medicare, anywhere in the U.S.

To help pay your out-of-pocket costs in Original Medicare (like your 20% coinsurance), you can also shop for and buy supplemental coverage.

If you don't get Medicare drug coverage or Medigap when you're first eligible, you may have to pay more to get this coverage later. This could mean you’ll have a lifetime premium penalty for your Medicare drug coverage.

Learn more about how Original Medicare works. 

*Follow the links for further information.

What's covered under Part A? In general, it covers:

• Inpatient care in a hospital
• Skilled nursing facility care
• Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)
• Hospice care
• Home health care

*Follow the links for further information.

Part B covers 2 types of services:

• Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
• Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best. You pay nothing for most preventive services if you get the services from a health care provider who accepts

Part B covers things like:

• Clinical research 
• Ambulance services
• Durable medical equipment (DME)
• Mental health
  • Inpatient
  • Outpatient
  • Partial hospitalization
• Limited outpatient prescription drugs

*Follow the links for further information.

You can get a Medicare Supplement Insurance (Medigap) policy to help pay your remaining out-of-pocket costs (like your 20% coinsurance). Or, you can use coverage from a former employer or union, or Medicaid.

·  For Part B-covered services, you usually pay 20% of the Medicare-approved amount after you meet your deductible. This is called your coinsurance.

·  You pay a premium (monthly payment) for Part B. If you choose to join a Medicare drug plan, you’ll pay a separate premium for your Medicare drug coverage (Part D).

·  There's no yearly limit on what you pay out of pocket, unless you have supplemental coverage–like Medicare Supplement Insurance (Medigap).

*Follow the links for further information.

• Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D.

• In most cases, you’ll need to use doctors who are in the plan’s network.

• Plans may have lower out-of-pocket costs than Original Medicare.

• Plans may offer some extra benefits that Original Medicare doesn’t cover—like vision, hearing, and dental services.