The following are the five choices you have when deciding on the type of coverage as a Medicare recipient:
- Original Medicare
- Medicare Advantage Plan
- Original Medicare+ Supplemental (Gap) Insurance
- Original Medicare+ Prescription Drug Plan
- Original Medicare+ Supplemental (Gap) Insurance + Prescription Drug Plan
Here’s another way to look at it:
Original Medicare (Medicare Part A + Medicare Part B)
Medicare Part A (Hospital Coverage) covers hospital inpatient care, skilled nursing facility (not custodial or long-term care), home health care, hospice care, blood transfusions, and in-patient care in a religious non-medical health care facility. Medicare Part B (Medical Insurance) covers doctors and other health care providers, outpatient care, home health care, durable medical equipment, and approved preventive services.
The majority of people over 65 years old automatically get enrolled into Medicare Parts A and B if you paid into Social Security for 10 years or more. If you contributed for fewer than 10 years to Social Security, then Medicare is still offered, though, at a premium fee.
A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.
Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare.
Not all Medicare Advantage Plans work the same way, so before you join, take the time to find and compare Medicare health plans in your area. Visit the plan’s website to see if you can join online or Fill out a paper enrollment form. When you join a Medicare Advantage Plan, you’ll have to give the information that is on your Medicare card.
Though Medicare pays a fee for to the Advantage plans, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care). These rules can change each year.