Choosing a Medicare plan can seem like a daunting process, but it doesn’t have to be. Truthfully, choosing a Medicare plan comes down to the benefits you’ll use the most and determining which plan offers you those benefits.
What does Original Medicare cover?
Original Medicare consists of two parts: Part A and Part B. Part A is Medicare’s inpatient coverage, which covers inpatient care in a hospital, skilled nursing facility care, hospice care, and home healthcare. Part B is Medicare’s medical insurance, which covers medically necessary services and preventive services.
Original Medicare can also include Medicare Supplements, which must be purchased separately. There are ten standardized supplement plans to choose from, all of which help cover costs that Medicare does not cover, and would have been initially your responsibility to pay.
What does Medicare Advantage cover?
Unlike Original Medicare, Medicare Advantage only consists of Part C, which provides the same amount of coverage offered by Original Medicare. However, Part C also provides additional benefits, such as:
- Adult day-care services
- Fitness club memberships
- Prescription drug coverage
- Services and supports for those with chronic conditions
- Transportation to doctor visits
Medicare Advantage generally comes in two different types: Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO). With a PPO Plan, you can choose any facility or provider to receive services from, but keep in mind that if you decide to go outside of your plan’s network to receive care, you will have to pay more in copayments and coinsurance. However, you may have some services covered but may have to pay a deductible before coverage takes place. You also do not need a referral to see a specialist.
With an HMO Plan, you are required to choose a primary care physician within the plan’s network and will need a referral to see a specialist. You also may have no coverage for any service received outside of your plan’s network. However, because of the little flexibility, you will have a lower premium payment.
What are my other Medicare coverage options?
Besides Original Medicare, Supplement Plans, and Advantage Plans, there is one more part to Medicare: Part D. Part D is the Medicare insurance plan that covers prescription drugs. If you want prescription drug coverage while enrolled in Original Medicare, then Part D is necessary, as Part A does not offer this type of coverage, and Part B only covers a limited amount of outpatient prescription drugs.
If you are interested in enrolling in a Medicare Advantage Plan, you can choose one of the Advantage Plans that offers it as a benefit.