Your Medicare coverage choices (2024)

New to Medicare? Get the basics.

When you first sign up for Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get Medicare: Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Some people need to get additional coverage, like Medicaredrug coverage or Medicare Supplement Insurance (Medigap).

Use this information to help you compare your coverage optionsand decide what coverage is right for you.

Original Medicare

  • Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
  • You can join a separate Medicare drug plan to get Medicare drug coverage(Part D).
  • You can use any doctor or hospital that takes Medicare, anywhere in the U.S.
  • To help pay your out-of-pocket costs in Original Medicare (like your 20% coinsurance), you can also shop for and buy supplemental coverage.

If you don't get Medicare drug coverage or Medigap when you're first eligible, you may have to pay more to get this coverage later. This could mean you’ll have alifetime premium penalty for your Medicare drug coverage.

Learn more about how Original Medicare works.

Medicare Advantage (also known as Part C)

  • Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D.
  • In most cases, you’ll need to use doctors who are in the plan’s network.
  • Plans may have lower out-of-pocket costs than Original Medicare.
  • Plans may offer some extra benefits that Original Medicare doesn’t cover—like vision, hearing, and dental services.

Learn more about how Medicare Advantage Plans work.

Compare your Medicare options

Can I get my health care from any doctor, other health care provider, or hospital?

Original Medicare

You can go to any doctor or hospital that takes Medicare, anywhere in the U.S.

In most cases, you don't need a referral to see a specialist.

Medicare Advantage

In many cases, you’ll need to only use doctors and other providers who are in the plan’s network (for non-emergency care). Some plans offer non-emergency coverage out of network, but typically at a higher cost.

You may need to get a referral to see a specialist.

Are prescriptions covered?

Original Medicare

You can join a separateMedicare drug plan (Part D)to get Medicare drug coverage.

Medicare Advantage

Medicare drug coverage is included in most plans. In most types of Medicare Advantage Plans, you can’t join a separate Medicare drug plan. You can join a separate Medicare drug planwithcertain types of plans that:

  • Can’t offer drug coverage (like Medicare Medical Savings Account plans)
  • Choose not to offer drug coverage (like some Private Fee-for-Service plans)

You’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare if both of these apply:

  • You’re in a Medicare Advantage HMO or PPO.
  • You join a separate Medicare drug plan.

Should I get a supplemental policy?

Original Medicare

You can get aMedicare Supplement Insurance (Medigap) policy to help pay your remaining out-of-pocket costs (like your 20% coinsurance). Or, you can use coverage from a former employer or union, or Medicaid.

Medicare Advantage

You can’t buy and don’t need Medigap.

What are my costs?

Original Medicare
  • For Part B-covered services, you usually pay 20% of the Medicare-approved amount after you meet your deductible. This is called your coinsurance.
  • You pay a premium (monthly payment) for Part B. If you choose to join a Medicare drug plan, you’ll pay a separate premium for your Medicare drug coverage (Part D).
  • There's no yearly limit on what you pay out of pocket, unless you have supplemental coverage–like Medicare Supplement Insurance (Medigap).

Learn about the factors that affect your Original Medicare out-of-pocket costs.

Medicare Advantage
  • Out-of-pocket costs vary—plans may have different out-of-pocket costs for certain services.
  • You pay the monthly Part B premium and may also have to pay the plan's premium. Plans may have a $0 premium or may help pay all or part of your Part B premium. Most plans include Medicare drug coverage (Part D).
  • Plans have a yearly limit on what you pay out of pocket for services Medicare Part A and Part B covers. Once you reach your plan’s limit, you’ll pay nothing for services Part A and Part B covers for the rest of the year.

Learn more about the costs forMedicare Advantage Plans.

Other options

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

Find out how Medicare drug coverage works with other insurance.

You can get personalized health insurance counseling at no cost to you from your localState Health Insurance Assistance Program (SHIP).

Your Medicare coverage choices (2024)

FAQs

What is Medicare group of answer choices? ›

Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that provides health coverage for some people with limited income and resources.

Does the social security office answer Medicare questions? ›

Although the Centers for Medicare & Medicaid Services (CMS) is the agency in charge of the Medicare program, Social Security processes your application for Original Medicare (Part A and Part B). We provide general information about the Medicare program and can help you get a replacement Medicare card.

How do I get answers to Medicare? ›

Live chat with us, and find local organizations that can help answer your Medicare questions. You can also: Call us at 1-800-MEDICARE (1-800-633-4227). Help from Medicare is available 24 hours a day, 7 days a week, except some federal holidays.

What is the difference between Medicare and Medicaid group of answer choices? ›

Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income. Medicaid is a state and federal program that provides health coverage if you have a very low income.

What are the 2 Medicare choices called? ›

Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). You can join a separate Medicare drug plan to get Medicare drug coverage (Part D). You can use any doctor or hospital that takes Medicare, anywhere in the U.S.

Is Medicare free at age 65 for seniors? ›

$0 for most people (because they or a spouse paid Medicare taxes long enough while working - generally at least 10 years). If you get Medicare earlier than age 65, you won't pay a Part A premium. This is sometimes called “premium-free Part A.”

Is there really a $16728 Social Security bonus? ›

Have you heard about the Social Security $16,728 yearly bonus? There's really no “bonus” that retirees can collect. The Social Security Administration (SSA) uses a specific formula based on your lifetime earnings to determine your benefit amount.

At what age is Social Security no longer taxed? ›

Social Security tax FAQs

Social Security income can be taxable no matter how old you are. It all depends on whether your total combined income exceeds a certain level set for your filing status. You may have heard that Social Security income is not taxed after age 70; this is false.

Does AARP help with Medicare questions? ›

The tool clarifies eligibility and enrollment requirements and provides answers to questions on Medicare's plan options, coverage and costs in an easy-to-understand manner. Choose a topic below and click “See all questions” to find the answers you are looking for.

Does Medicare cover 100% of hospital bills? ›

Medicare doesn't typically cover 100% of your medical costs. Like most health insurance, Medicare generally comes with out-of-pocket costs including copayments, coinsurance, and deductibles. As you'll learn in this article, Original Medicare (Part A and Part B) costs can really add up.

Why do doctors not like Medicare Advantage plans? ›

In some cases, your doctor may not agree with your insurance provider's decision to approve a less expensive treatment before paying for a more expensive one that your doctor may recommend. Providers in Medicare Advantage networks may also have to take time away from patients to spend it on pre-authorization paperwork.

Do you really need a medicare supplement plan? ›

Supplemental insurance is advisable for those with Medicare to help cover out-of-pocket costs and gaps in coverage, offering financial protection for deductibles, coinsurance, and other medical expenses not fully covered by Medicare.

What is Medicare quizlet? ›

What is Medicare? Federal program that provides health insurance coverage to people ages 65 and older and younger people with permanent disabilities. The 4 part program covers all those who are eligible regardless of their health status, medical conditions, or incomes.

What is the meaning of Medicare? ›

A U.S. federal health insurance program for people aged 65 years or older and people with certain disabilities.

What is a Medicare group? ›

Group Medicare Advantage plans are insurance plans offered by employers or unions to their retirees. EGWPs are provided by private insurance companies who manage your company's retiree Medicare benefits. Under EGWPs, Medicare pays the insurance company a fixed amount to provide benefits.

What is the major purpose of Medicare? ›

In July 1965, under the leadership of President Lyndon Johnson, Congress enacted Medicare under Title XVIII of the Social Security Act to provide health insurance to people age 65 and older, regardless of income or medical history.

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