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Your Medicare coverage choices

Note

Are you new to Medicare? Before you choose your coverage, learn about the different parts of Medicare and steps to get you started with Medicare.

There are 2 main ways to get your Medicare coverage— Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Some people get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). Use these steps to help you decide what coverage you want:

Step 1: Decide if you want Original Medicare or a Medicare Advantage Plan (Iike an HMO or PPO)

Here are some things you should know:

What's Original Medicare?

Part A (Hospital Insurance) and Part B (Medical Insurance).

Who provides coverage?

Medicare

How do you choose your providers?

You have your choice of doctors, hospitals, and other providers that accept Medicare.

How much does it cost?

  • Most people pay the Part B premium of $104.90 each month (this amount won’t change in 2015).

  • Generally, you pay a deductible and coinsurance for your Part A and Part B services. If you choose to buy a Medicare Supplement Insurance (Medigap) policy (see Step 3), your Medigap policy may pay some of these costs.
  • Learn more about Part A and Part B costs.

Learn more about how Original Medicare works.

Here are some things you should know:

What's Medicare Advantage?

Sometimes called "Part C" – includes both Part A (Hospital Insurance) and Part B (Medical Insurance).

Who provides coverage?

Private insurance companies approved by Medicare.

How do you choose your providers?

In most MA plans, you need to use plan doctors, hospitals, and other providers or you pay more or all of the costs.

How much does it cost?

  • Most people pay the Part B premium of $104.90 each month (this amount won’t change in 2015).

  • You usually pay a monthly premium for your MA Plan (in addition to your monthly Part B premium).
  • You may pay a copayment or coinsurance for covered services. Costs, extra coverage, and rules vary by plan.\
  • Learn more about costs for MA plans.

Learn more about how MA plans work.

Step 2: Decide if you want prescription drug coverage (Part D)

If you want prescription drug coverage, you must choose and join a Medicare Prescription Drug Plan. You usually pay a monthly premium.

These plans are run by private companies approved by Medicare. Learn more about how to get drug coverage.

If you want prescription drug coverage, and it's offered by your MA plan, in most cases you must get it through your plan. Learn more about how to get drug coverage.

Step 3: Decide if you want supplemental coverage

You may want to get coverage to help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles. You can choose to buy a Medigap policy from a private company.

Learn more about Medigap policies.

If you join an MA Plan, you can’t use Medigap insurance to pay for your plan costs, like copayments, deductibles, and premiums.

Learn more about how Medigap policies work with MA Plans.

Other options

Note

You can get personalized health insurance counseling at no cost to you from your local State Health Insurance Assistance Program (SHIP).