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Original Medicare

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care
  • Services from doctors and other health care providers
  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Some preventive services

Medicare Advantage

  • Run by Medicare-approved private insurance companies
  • Includes all benefits and services covered under Part A and Part B
  • Usually includes Medicare prescription drug coverage (Part D) as part of the plan
  • May include extra benefits and services for an extra cost

Drug Card

  • Run by Medicare-approved private insurance companies
  • Helps cover the cost of prescription drugs
  • May help lower your prescription drug costs and help protect against higher costs in the future

Medicare Supplement

A Medicare Supplement Insurance (Medigap) policy helps pay some of the health care costs that Original Medicare doesn't cover, like:

  • Copayments
  • Coinsurance
  • Deductibles
Medicare ​Part A

Part A (Hospital Insurance) helps cover:

  • Inpatient care in hospitals
  • Inpatient care in a skilled nursing facility (not custodial or long-term care)
  • Hospice care services
  • Home health care services
  • Inpatient care in a Religious Nonmedical Health Care Institution

You can find out if you have Part A by looking at your Medicare card.  If you have Original Medicare, you’ll use this card to get your Medicare-covered services.  If you join a Medicare health plan, in most cases, you must use the card from the plan to get your Medicare-covered services.

What Does Medicare Part B Cover?

Part B (Medical Insurance) helps cover:

  • Medically-necessary doctors’ services
  • Outpatient care
  • Home health services
  • Durable medical equipment
  • Other medical services
  • Many preventive services

You can find out if you have Part B by looking at your Medicare card.

​Medicare Advantage

Medicare Advantage Plans are health plan options that are approved by Medicare but run by private companies. 

They are part of the Medicare Program, and sometimes called "Part C." 

  • In most cases, the premiums or the costs of services (co-pays and deductibles ) can be lower than they are in the Original Medicare Plan or the Original Medicare Plan with a Medigap policy. Medicare Health Plans charge different premiums and have different costs of services, so it is important to check with the plan before you join.
  • The plans provide all of your Part A (hospital) and Part B (medical) coverage and must cover medically-necessary services.
  • Some of the plans require referrals to see specialists.
  • They often have networks, which means you may have to see doctors who belong to the plan or go to certain hospitals to get covered services.
  • They generally offer extra benefits, and many include prescription drug coverage.
  • In many cases, your costs for prescription drug coverage can be lower than in the stand-alone Medicare Prescription Drug Plans.
  • Some of the plans coordinate your care, using networks and referrals, more than others. This can help manage your overall care and can also result in savings to you.
  • You don't need to buy a Medigap policy.
How does Medicare prescription drug coverage (Part D) work?

To get Medicare prescription drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and specific drugs covered.

There are 2 ways to get Medicare prescription drug coverage:

1.Medicare Prescription Drug Plans. These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.

2.Medicare Advantage Plans (like an HMO or PPO) or other Medicare health plans that offer Medicare prescription drug coverage.You get all of your Part A and Part B coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MAPDs.” You must have Part A and Part B to join a Medicare Advantage Plan.

In either case, you must live in the service area of the Medicare drug plan you want to join. 

Medigap Plans Effective on or After June 1, 2017

How to read the chart:

If a check mark appears in a column of this chart, the Medigap policy covers 100% of the described benefit.  

If a row lists a percentage, the policy covers that percentage of the described benefit.  

If a row is blank, the policy does not cover that benefit.     

Note:    The Medigap policy covers coinsurance only after you have paid the deductible (unless the Medigap policy also covers the deductible.)