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Navigating the Different Types of Medicare Plans
For people aged 65 and older, as well as those younger than 65 with certain disabilities, there are many different Medicare coverage options available. When deciding what type of plan you need, it’s helpful to understand what’s included with each plan and to compare costs. It’s also important to consider whether or not your current physician(s) can accept your plan and coverage for prescription drugs you may need to take. Let’s review the different types of Medicare coverage so you can have a greater understanding of the options available to you.Original Medicare: The Foundation of Your Coverage
Original Medicare consists of Part A (hospital insurance) and Part B (medical insurance). Part A helps cover inpatient care in hospitals, skilled nursing facility care, hospice, and some home health care. Part B covers medically necessary services from doctors and other healthcare providers, as well as outpatient care, durable medical equipment, and many preventive services. When you have Original Medicare, you can go to any doctor or hospital in the U.S. that accepts Medicare, and the government pays a portion of the costs for covered services.How to Fill the Gaps in Original Medicare
Original Medicare (Part A and Part B) provides a solid foundation of coverage for hospital stays and medical services, but it doesn’t cover everything and can leave you with out-of-pocket costs. Coverage gaps can include deductibles, coinsurance, and copayments, as well as a lack of an annual out-of-pocket maximum, meaning there is no limit to how much a beneficiary could pay in a year. Supplemental Medicare coverage can help to fill these gaps. Medicare Advantage (Part C) plans, offered by private companies, are an alternative to Original Medicare but may include additional routine benefits. Medicare Supplement plans (Medigap) are separate policies that work alongside Original Medicare to help pay for out-of-pocket costs like deductibles, coinsurance, and copayments. For beneficiaries concerned about prescription costs, Medicare Part D plans are stand-alone prescription drug plans that can be added to Original Medicare to help cover the cost of medications.Exploring Medicare Advantage Plans (Part C)
Medicare Advantage plans are offered by private health insurance companies that are approved by Medicare. While these plans are legally required to offer the same coverage as Original Medicare, they may also include additional routine benefits. If you decide to purchase a Medicare Advantage plan, you may or may not have to pay a monthly premium. Some plans require a deductible, while others do not—copayments and coinsurance can vary greatly with Medicare Advantage plans. For example, one plan may charge you a 20% coinsurance to see a primary care doctor, and another may charge you $0. When considering a Medicare Advantage plan, it’s important to consider all of the available plans in your area to ensure you get the right plan for your needs. A SelectQuote licensed insurance agent can help you compare the Medicare Advantage plans that may be available to you.Getting Prescription Drug Coverage (Part D)
Prescription medications you take at home are not typically covered by Original Medicare. If you want prescription drug coverage, you have two options:- Enroll in a stand-alone Medicare Part D plan (Prescription Drug plan) that works alongside Original Medicare
- Choose a Medicare Advantage plan that also includes prescription drug coverage
Medicare Supplement Plans (Medigap)
Medicare Supplement insurance plans, also commonly referred to as Medigap plans, help with gaps in coverage from Medicare Parts A and B, including copayments, coinsurance, and deductibles. Medicare Supplement plans generally cover Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted. Additionally, they generally cover:- At least 50% of Medicare Part B coinsurance or copayment
- The first three pints of blood received in a medical procedure
- Part A hospice care coinsurance or copayment
- The skilled nursing facility care coinsurance
- Medicare Part A deductible
- Medicare Part B deductible
- Medicare Part B excess charges
- Foreign travel emergencies up to plan limits
Finding the Right Type of Medicare Plan For Your Needs
Deciding what kind of coverage is right for you can be complex and overwhelming, especially when there are so many different types of Medicare plans available. At SelectQuote, we can help you review your options in just minutes. Our licensed insurance agents can compare Medicare Advantage plans available to you, answer any questions you have about coverage, and help you determine what might be the right option for you.Comparing Medicare Plans to Find Your Right Fit
Comparing Medicare plans will help you decide what type of coverage will suit your healthcare needs. Read on to compare the differences between Original Medicare and Medicare Advantage plans.Medicare Plans Comparison Chart by Coverage Type
| Coverage Type | Original Medicare | Medicare Advantage |
| Hospital Insurance | Inpatient hospitalsSkilled nursing homesHome health and hospice care | Inpatient hospitalsSkilled nursing homesHome health and hospice care |
| Medical Insurance | Routine doctor visitsSpecialist visitsPreventative services | Routine doctor visitsSpecialist visitsPreventative services |
| Prescription Drug Coverage | Not available. Would require an additional stand-alone Prescription Drug plan | Plans with Prescription Drug coverage available |
| Additional Coverage | Not available. Would require an additional Medicare Supplement plan | Plans with additional coverage available (vision, dental, etc.) |
Medicare Plans Comparison Chart by Coverage Cost
Medicare plans, like Original Medicare plans and Medicare Advantage plans, vary in their coverage and costs. Medicare costs often differ by income, work qualifications, and the amount of coverage needed. It’s important to note that Medicare Advantage plans typically have less out-of-pocket costs compared to Original Medicare plans.| Coverage Costs | Original Medicare | Medicare Advantage |
| Premiums | Premiums vary by income and work qualifications | Premiums vary by income and plan |
| Deductibles | Recurring deductible by benefit period | Deductible costs generally don’t apply |
| Coinsurance (copayment) | 20% coinsurance for outpatient care | Copay varies by plan and type of care |
| Out-of-Pocket Maximum | No maximum for Original Medicare | Maximum will vary by plan |
Let SelectQuote Find the Right Type of Medicare Plan For You
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