Medicare supplements - Medicare Advantage Plans - Individual Health - Long Term Care
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Medicare Advantage & Medicare Advantage Plans
Original Medicare A & B
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Medicare Part A
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Medicare Part A (Hospital insurance) covers inpatient hospital care, critical access care, short-term care in skilled nursing facilities, hospice and some home health care. Medicare typically does not pay for assisted living facilities, nursing homes or long-term care at home. Part A is free to most Medicare beneficiaries if the beneficiary or their spouse paid Medicare taxes while they were working. If an individual is not eligible to receive Part A free-of-charge then the individual may be eligible to sign up for Part A coverage.
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Medicare Part B
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Medicare Part B (Medical Insurance) covers visits to the doctor, outpatient care, some preventative services, as well as some occupational and physical therapy. It may require a monthly premium, which is often based on beneficiary income. It is important to remember that Medicare Part B does not cover 100 percent of services and beneficiaries will be responsible for the balance of expenses not paid for by Medicare.
Medicare Supplements
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Medicare Part D
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Prescription Drug Coverage
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Prescription Drug Coverage is offered through private insurance companies that contract with Medicare. For a monthly premium, Prescription Drug Coverage gives you access to the necessary medication you might need.
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Medigap
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Supplement Insurance
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Medigap plans are also sold through private insurance companies to cover services for which Medicare does not cover, or only partially covers. This may include co-insurance, co-payments, deductibles and the "gaps" between what Medicare pays and the total expenses.
Medicare Advantage Plan
Part C
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Medicare Advantage Plans cover the same services as Medicare Part A and Part B combined, and also includes prescription drug coverage. Advantage Plans may also include benefits not offered with traditional Medicare, such as vision and dental. These plans are offered by private companies that contract with Medicare, which means you can choose your preferred plan whether it is a Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), or Private Fee-for-Service.
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Replace Part A and Part B
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Usually include Part D prescription drug coverage
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Provides extra benefits not covered by original medicare such as routine vision and dental care
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May have coverage restrictions such as provider networks and prior authorization
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Limits members to using doctors and hospitals in network
​Medicare Advantage Plans vs
Medicare Supplement Plans
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Work with Part A and Part B
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Pay your out-of-pocket costs with Original Medicare
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Does not include Part D prescription drug costs
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Can be used with any hospital or doctor in the US that accepts Medicare
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No need for prior authorizations or referrals from a primary care doctor