Your Medicare coverage choices | Medicare

Note
New to Medicare? Get the basics.

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get Medicare :

Original Medicare

( Part A and Part B ) or a

Medicare Advantage Plan (Part C)

. Some people need to get extra coverage, like Medicare drug coverage or Medicare Supplement Insurance ( Medigap ) .
Use this data to help you compare your coverage options and decide what coverage is right field for you .

Original Medicare

  • 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.

Note
If you do n’t get Medicare drug coverage or Medigap when you ‘re first eligible, you may have to pay more to get this coverage by and by. This could mean you ’ ll have a life premium penalty for your Medicare drug coverage .

Learn more about how original Medicare works .

Medicare Advantage

(also known as Part C)

  • 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.

Learn more about how Medicare Advantage Plans function .

Compare your Medicare options

Can I get my health care from any doctor, other health care provider, or hospital?

Original Medicare
You can go to any doctor or hospital that takes Medicare, anywhere in the U.S .
In most cases, you do n’t need a

referral

to see a specialist .

Medicare Advantage
In many cases, you ’ ll indigence to entirely use doctors and other providers who are in the design ’ mho network ( for non-emergency caution ). Some plans offer non-emergency coverage out of net, but typically at a higher cost .
You may need to get a

referral

to see a specialist .

Are prescriptions covered?

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

Medicare Advantage
Medicare drug coverage is included in most plans. In most types of Medicare Advantage Plans, you can ’ triiodothyronine join a divide Medicare drug plan. You can join a offprint Medicare drug plan with certain types of plans that :

  • Can ’ t offer drug coverage ( likeMedicare Medical Savings Account plans )
  • Choose not to offer drug coverage (like some

    Private Fee-for-Service plans

    )

You ’ ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare if both of these apply :

  • You ’ re in a Medicare advantageHMO orPPO .
  • You join a separate Medicare drug plan.

Should I get a supplemental policy?

Original Medicare
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 .
Medicare Advantage
You can ’ thymine bargain and don ’ t need Medigap .

What are my costs?

Original Medicare
  • 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).

Learn about the factors that affect your original Medicare out-of-pocket costs .

Medicare Advantage
  • Out-of-pocket costs vary—plans may have different out-of-pocket costs for certain services.

  • You pay the monthly Part B premium and may also have to pay the plan’s premium. Plans may have a $0 premium or may help pay all or part of your Part B premium. Most plans include Medicare drug coverage (Part D).

  • Plans have a yearly limit on what you pay out of pocket for services Medicare Part A and Part B covers. Once you reach your plan’s limit, you’ll pay nothing for services Part A and Part B covers for the rest of the year.

Learn more about the costs for Medicare Advantage Plans .

Other options

  • In addition to Original Medicare or an MA Plan, you may be able to join other types of 

    Medicare health plans. 

  • You may be able to save money or have other coverage choices if you have limited income and resources. 

    Get help paying costs

    .

  • You may also have other coverage, like employer or union, military, or veterans’ benefits. 

    Learn about how Medicare works with other insurance

    .

Find out how medicare drug coverage works with other policy.

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