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There Are Choices for Medicare Coverage

Original and advantage plans help steer you to the best option

By Centers for Medicare & Medicaid Services | May 13, 2012
close-up of medicare card
Ingram Publishing | Thinkstock

There are two main choices for how you get your Medicare coverage. Use these steps to help you decide:

First, decide if you want original medicare or a medicare advantage plan.

Original Medicare Medicare advantage plan (like an HMO or PPO)
Part A (hospital insurance) and Part B (medical insurance) Part C (includes both Part A and Part B)
  • Medicare provides this coverage
  • You have your choice of doctors, hospitals and other providers that accept Medicare
  • Generally, you or your supplemental coverage pay deductibles and coinsurance
  • You usually pay a monthly premium for Part B
  • Private insurance companies approved by Medicare provide this coverage.
  • In most plans, you need to use plan doctors, hospitals, and other providers or you pay more or all of the costs.
  • You usually pay a monthly premium (in addition to your Part B premium) and a copayment or coinsurance for covered services.
  • Costs, extra coverage, and rules vary by plan.
Decide if you want prescription drug coverage (Part D) 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.
Decide if you want supplemental coverage Continue below
  • 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.

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