Turning 65 soon? It’s time to explore your Medicare options.
Speak with a licensed insurance agent about your Medicare options
Original Medicare: What it covers and what it doesn’t
Original Medicare is offered by the federal government and is made up of Part A and Part B. It covers 80% of covered services, meaning Medicare patients enrolled in Original Medicare are responsible for paying 20% out of pocket with no cap.
Original Medicare also does not cover prescription drugs, vision, dental, or hearing. For Medicare patients who want this additional coverage, there are a couple of choices available.
Hospital stays and inpatient care (Part A)
Doctor visits and outpatient care (Part B)
Routine hearing and hearing aids
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Options for additional Medicare coverage
To cap out of pocket expenses, Medicare enrollees can sign up for a Medigap plan, but Medigap does not provide coverage for prescriptions. To get prescription coverage with a Medigap plan, enrollees will need a Part D plan, as well.
The other option is a Medicare Advantage plan (also known as Part C), which combines Part A and Part B and often includes prescription coverage (Part D) and other benefits not offered by Original Medicare, including vision, dental, hearing, and even transportation.
Medicare Advantage versus Original Medicare
Improved health: Medicare Advantage plans support your primary care doctor’s care plan. They help ensure you get preventive care like wellness visits, tests, checkups and vaccines. With Medicare Advantage plans, members are often healthier and need less acute and chronic care.
Cost savings: Medicare Advantage limits the total amount you pay for covered services. With Original Medicare, you pay 20% of the cost for covered services, with no limit to your total costs. You can buy a supplement plan to help with those costs. And you can add a Medicare Part D plan to cover prescription drugs. But a Medicare Advantage plan may offer you everything you need, all in one plan. Be sure to look carefully at your choices, so you can find a plan that best fits your needs.
with their Medicare Advantage plan.1
with the preventive care their Medicare Advantage plan offers.2
A few important things to know about Medicare Advantage
A Medicare supplement insurance plan (Medigap policy) is not a Medicare Advantage plan. Medicare supplement plans are health insurance policies and are secondary to Original Medicare. Medicare Advantage plans combine Original Medicare Parts A and B, and sometimes Part D, into a single plan.
Medicare Advantage has you covered. Medicare Advantage plans must cover all the services that Original Medicare covers, and may offer additional benefits. Hospice care is still covered under Original Medicare. You may also receive more benefits if you have TRICARE for Life or VA coverage.
You have a built-in financial safety net. Your plan’s annual out-of-pocket maximum is your safety net that ensures you’ll never pay more than a certain amount out of pocket in a given plan year for covered medical services.
1The Coalition for Medicare Choices. 2 million seniors and The Coalition for Medicare Choices mobilize to support Medicare Advantage. medicarechoices.org/2-million-seniors-and-the-coalition-for-medicare-choices-mobilize-to-support-medicare-advantage/. Published January 31, 2018. Accessed February 15, 2019.
2Better Medicare Alliance. Seniors highly satisfied with Medicare Advantage. bettermedicarealliance.org/newsroom/press-releases/seniors-highly-satisfied-medicare-advantage. Published March 11, 2015. Accessed February 15, 2019.