Your Medicare coverage choices

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get your Medicare coverage—

 (Part A and Part B) or a 

. Some people need to 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 (like an HMO or PPO)

You can choose Original Medicare.

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). In 2019, the standard Part B premium amount is $135.50 (or higher depending on your income).

• Generally, you pay a
  Deductible [glossary]
  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.

You can choose a Medicare Advantage (MA) Plan.

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).  Some plans have a $0 premium or will help pay all or part of your Part B premium.  

• 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
  may be 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)

You chose Original Medicare in Step 1. [If you want]

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.

You chose a Medicare Advantage (MA) Plan in Step 1. [If you want]

If you want prescription drug coverage, and it's offered by your MA plan, in most cases you must get it through your plan. Learn more about how to get drug coverage.

Find an MA plan.

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

Step 3: Decide if you want supplemental coverage

You chose Original Medicare in Step 1. [You may want]

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.

You chose a Medicare Advantage (MA) Plan in Step 1. [Your cost sharing is lower]

You can’t buy or use separate supplemental coverage—but some plans have lower out-of-pocket costs than Original Medicare. 

Learn more about how Medigap policies work with MA Plans.

Other options

• In addition to Original Medicare or an MA Plan, you may be able to join other types of Medicare health plans.  
• You may be able to save money or have other choices if you have limited income and resources. Get help paying costs.
• You may also have other coverage, like employer or union, military, or veterans' benefits. Learn about how Medicare works with other insurance. Find out how Medicare Part D (prescription drug coverage) works with other insurance.