Medicare is a federal health insurance program. It is available to people 65 and older, people under 65 with certain disabilities and people with end-stage renal disease. When you are ready to decide on a plan, take the time to understand how the plans work. That way, you can make an informed decision and choose the plan that is right for you.
When It Comes to Coverage, You Have Options
You have the choice of your Medicare coverage. There are two primary options, Original Medicare and Medicare Advantage (also known as Part C).
What are the parts of Medicare?
Original Medicare is a fee-for-service health plan managed by the federal government that has two parts: Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). For drug coverage, you can join a separate Medicare drug plan (Part D).
Learn more about the individual parts of Medicare:
Part A - Hospital Coverage
- Inpatient care in hospitals
- Skilled nursing facility care
- Hospice care
- Home health care
Part B - Medical Coverage
- Services from doctors and other health care providers
- Outpatient care
- Home health care
- Durable medical equipment (like wheelchairs, walkers, hospital beds and other equipment)
- Many preventive services (like screenings, shots/vaccines and yearly "Wellness" visits)
Medicare Advantage (also known as Part C)
- An "all in one" alternative to Original Medicare that includes Part A, Part B and, usually, Part D.
- Plans may have lower out-of-pocket costs than Original Medicare.
- Most plans offer extra benefits that Original Medicare doesn't cover such as vision, hearing, dental and more.
Part D - Prescription Drug Coverage
- Cost of prescription drugs (including many recommended shots and vaccines)
Part D plans are run by private insurance companies that follow rules set by Medicare.
What are Medicare Advantage plans?
A Medicare Advantage Plan is another way to get your Medicare Part A (hospital insurance) and Part B (Medicare insurance) coverage. Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies that are approved by Medicare.
If you join a Medicare Advantage Plan, the plan will provide all of your Medicare Part A and Part B coverage, excluding hospice care. Most plans also include drug coverage (Part D). Medicare Advantage plans often offer coverage for things Original Medicare doesn't cover, such as vision, hearing, dental, and fitness programs (like gym memberships or discounts).
There are different types of Medicare Advantage plans. The most common types of plans include:
- Health Maintenance Organization (HMO) Plans
- Preferred Provider Organization (PPO) Plans
- Private Fee-for-Service (PFFS) Plans
- Special Needs Plans (SNPs)