Skip Navigation

Your Medicare coverage choices

Note

Are you new to Medicare? Before you choose your coverage, learn about the different parts of Medicare and steps to get you started with Medicare.

There are 2 main ways to get your Medicare coverage—Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Some people get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). Use these steps to help you decide what coverage you want:

Step 1: Decide if you want Original Medicare or a Medicare Advantage Plan (Iike an HMO or PPO)

Here are some things to know:

What's Original Medicare?

Part A (Hospital Insurance) and Part B (Medical Insurance).

Who provides coverage?

Medicare

How do you choose your providers?

You have your choice of doctors, hospitals, and other providers that accept Medicare.

How much does it cost?

  • In 2018, the standard Part B premium amount is $134 (or higher depending on your income). However, some people who get Social Security benefits pay less than this amount ($130 on average in 2018).

  • Generally, you pay a deductible and coinsurance for your Part A and Part B services. If you choose to buy a Medicare Supplement Insurance (Medigap) policy (see Step 3), your Medigap policy may pay some of these costs.
  • Learn more about Part A and Part B costs.

Learn more about how Original Medicare works.

Here are some things to know:

What's Medicare Advantage?

Sometimes called "Part C" – includes both Part A (Hospital Insurance) and Part B (Medical Insurance).

Who provides coverage?

Private insurance companies approved by Medicare.

How do you choose your providers?

You may need to use health care providers who participate in the plan’s network.

How much does it cost?

  • In 2018, the standard Part B premium amount is $134 (or higher depending on your income). However, some people who get Social Security benefits pay less than this amount ($130 on average in 2018).

  • You usually pay a monthly premium for your MA Plan (in addition to your monthly Part B premium).
  • You may pay a copayment or coinsurance for covered services. Many MA plans offer vision, hearing, and dental coverage. Costs, extra coverage, and rules vary by plan.
  • Plans have a yearly limit on your out-of-pocket costs. Once you reach a certain limit, you’ll pay nothing for covered services for the rest of the year.
  • Your out-of-pocket costs are typically lower in an MA plan. This option may be more cost effective for you.
  • Learn more about costs for MA plans.

Learn more about how MA plans work.

Find an MA plan.

 

Step 2: Decide if you want prescription drug coverage (Part D)

If you want prescription drug coverage, you must choose and join a Medicare Prescription Drug Plan. You usually pay a monthly premium.

These plans are run by private companies approved by Medicare. Learn more about how to get drug coverage.

Find a Medicare drug plan.

Find out how Medicare prescription drug coverage works with other insurance.

Step 3: Decide if you want supplemental coverage

You may want to get coverage to help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles. You can choose to buy a Medigap policy from a private company.

Note

The same insurance company may offer Medigap policies and Medicare Prescription Drug Plans.

If you join a Medigap policy and a Medicare drug plan offered by the same company, you may need to make 2 separate premium payments for your coverage. Contact your insurance company for more details.

Learn more about Medigap policies.

Find a Medigap policy.

Your cost sharing is lower (or included) if you’re in a Medicare Advantage Plan. You can’t use (and can’t be sold) a Medigap policy if you’re in a Medicare Advantage Plan.

Learn more about how Medigap policies work with MA Plans.

Other options

Note

You can get personalized health insurance counseling at no cost to you from your local State Health Insurance Assistance Program (SHIP).