When first enrolling in Medicare, beneficiaries are introduced to traditional Medicare coverage, coined Original Medicare. Original Medicare insurance is not designed to cover everything recipients will need, and the gaps in coverage can be filled by signing up for Medicare-approved options.
Special rules apply for Medicare recipients who continue to work and retain health insurance through an employer or union. For others, the options are as follows:
- Original Medicare, which includes Parts A and B.
- Original Medicare plus Part D plus supplemental coverage (Medicare Supplement, or Medigap).
- Medicare Advantage, which bundles Part A, Part B and often Part D.
Medicare Advantage benefits
Medicare Advantage is known as Part C and is sometimes referred to as the MA plan. This type of plan is only available through Medicare-approved private insurance companies.MA plans are required to include the same Part A and Part B coverage as Original Medicare. In addition to Part D for prescription drugs, most MA plans today feature Medicare coverage offerings such as vision, hearing, dental and wellness programs. As the trend is toward care that extends beyond hospital inpatient services and primary physician sick visits, look for additional benefits like transportation to the doctor’s office, over-the-counter drugs and adult day care.
How to enroll in Medicare Advantage
Signing up for Parts A and B through the Social Security Administration is the first step whether you opt for Original Medicare or an MA plan. The easiest way to apply is through the SSA website. Then research the MA plans available in your location, and compare benefits. Pay particular attention to whether or not the plan includes prescription drugs. If you select a plan that does not cover prescription drugs, and you want that coverage, you would need to enroll in Part D coverage separately.
The Centers for Medicare & Medicaid Services will mail the beneficiary a Medicare insurance card, and the plan administrator of the MA plan will mail a membership card. In some cases, such as with hospital services, the Medicare card may need to be shown. But typically, it is the MA plan card that should be carried at all times and presented to healthcare providers when services are rendered.
Popularity of Part C
Based on enrollment statistics, the MA plan is a favored alternate to Original Medicare. Kaiser Family Foundation attributes increased enrollment to gradual changes in Medicare payment policy for Part A and Part B Medicare-covered services. Whereas the policy historically slanted toward generating savings, the focus has shifted over the years toward expansion of access to Medicare-approved private plans and the provision of additional benefits for participants. KFF advises that 34% of Medicare recipients in 2019 enrolled in Medicare Advantage plans and that the Congressional Budget Office expects this enrollment to reach 47% by 2029.
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