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Coverage Choices

There are two main ways to get your Medicare coverage:

  • Original Medicare (Parts A and B), or
  • Medicare Advantage Plan (Part C)

Original Medicare is one of your health coverage choices. You will have Original Medicare unless you choose to join a Medicare Advantage Plan or other Medicare health plan. You can see any doctor or provider that is enrolled in Medicare and accepting new patients. You don't need referrals.

In Original Medicare, if you have Medicare Part A and/or Part B, you get all the Part A and/or Part B-covered services listed under Medicare Basics - Part A and Medicare Basics - Part B.You must pay a monthly Part B premium to get Part B-covered services. You may also have to pay additional costs like a deductible, coinsurance, or copayment for most Medicare-covered services.

TIP: In addition to Original Medicare, you can get more coverage to help pay your health care costs:
  • A Medicare Prescription Drug Plan
  • A Medigap (Medicare Supplement) Insurance Policy
  • You must have both Medicare Part A and Part B to join a Medicare Advantage Plan (like an HMO or PPO). These plans are available in most areas of the country. If you join a Medicare Advantage Plan, you will get your Part A and Part B-covered services through the Medicare Advantage Plan. The plan may also offer extra coverage, such as vision (may or may not include contact lens or eyeglasses), hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (usually for an extra cost). Some Medicare Advantage Plans have provider networks. This means you probably have to see doctors who belong to the plan or go to certain hosptials to get covered services (other than for emergency or urgently-needed care or medically-necessary dialysis). You may need referrals to see specialists.

    Important! If you join a Medicare Advantage Plan, you don't need and can't use a Medigap (Medicare Supplement Insurance) policy. In most cases, you can't join a separate Medicare Prescription Drug Plan.

    There are advantages and disadvantages to each coverage choice. Click here to see a chart showing the difference between a Medicare Advantage and a Medicare Supplement plan.

     

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