Your Medicare coverage choices

There are 2 main ways to get your Medicare coverage— Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Use these steps to help you decide which way to get your coverage:

Step 1: Decide if you want Original Medicare or a Medicare Advantage Plan

Here are some things you should know:

What is Original Medicare?

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

Who provides coverage?

Medicare provides this coverage.

How do you choose your providers?

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

Who pays the premiums?

You usually pay a monthly premium for Part B.

Who pays deductibles and coinsurance?

Generally, you or your supplement coverage pay deductibles and coinsurance.

Here are some things you should consider about Medicare Advantage Plans:

What is it?

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

Who provides coverage?

Private insurance companies approved by Medicare provide this coverage.

How do you choose your providers?

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

Who pays the premiums?

You usually pay a monthly premium (in addition to your Part B premium).   

Who pays deductibles and coinsurance?

You may pay a copayment or coinsurance for covered services. Costs, extra coverage, and rules vary by plan.

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

If you want this 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.

If you want prescription drug coverage, and it's offered by your plan, in most cases you must get it through your plan.

In some types of plans that don't offer drug coverage, you can join a Medicare Prescription Drug Plan.

Step 3: Decide if you want supplemental coverage (Original Medicare only)

You may want to get coverage that fills gaps in Original Medicare coverage. You can choose to buy a Medicare Supplement Insurance (Medigap) policy from a private company.

  • Costs vary by policy and company.
  • Employers/unions may offer similar coverage.
Note

If you join a Medicare Advantage Plan, you can't use Medicare Supplement Insurance (Medigap) to pay for out-of-pocket costs you have in a Medicare Advantage Plan. If you already have a Medicare Advantage Plan, you can't be sold a Medigap policy. You can only use a Medigap policy if you disenroll from your Medicare Advantage Plan and return to Original Medicare.

Other options

  • In addition to Original Medicare or a Medicare Advantage Plan, you may be able to join other types of Medicare health plans.  
  • You may be able to save money or have other choices if you have limited income and resources.
  • You may also have other coverage, like employer or union, military, or veterans' benefits.
Note

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