Medicare isn’t just a single health plan. There are various parts, some of which you get from the government and others that you can purchase from private insurance companies. Parts A and B make up what’s known as original Medicare, which comes directly from the government.
Part A. You can think of Part A as hospital insurance. It helps pay a portion of the costs for any inpatient health care services you receive while in a hospital, a skilled nursing facility, or hospice care. It also offers coverage for some home health services. Part A is funded through a payroll tax. So, if you or your spouse worked for at least 10 years, you’ve probably already paid for it and won’t need to pay a premium.
Part B. This part of Medicare helps pay for basic outpatient health care services, medical supplies, and preventive care you get at the doctor’s office. You do pay a premium for Part B. The amount varies depending on factors such as your income.
While it may seem as if original Medicare covers a lot, there are plenty of gaps. Parts A and B don’t include any coverage for prescription drugs, for example, nor do they cover vision, dental, or hearing care. Original Medicare also doesn’t provide coverage for long term care. It’s also important to understand that coverage isn’t 100 percent for even the things parts A and B do cover, so you may still pay out of pocket when you seek care in the form of copays, coinsurance, and deductibles.
Medicare supplement plans, sometimes called Medigap plans, were developed to help cover the gaps. Medicare supplement plans are available from private insurance companies and can complement your original Medicare. These plans may help pay some out-of-pocket expenses, as well as add coverage for dental or other types of care.
Part D plans are a specific type of supplemental coverage for prescription drugs. They add coverage to help you pay for medications.
Medicare Advantage plans
Medicare Advantage plans, also known as Part C, offer an “all-in-one” alternative to purchasing original Medicare plus supplemental coverage. Medicare Advantage plans cover all of the same benefits as original Medicare, plus a lot of the benefits you might get from Medicare supplement plans, including prescription drug coverage. Only instead of having separate plans, you get it all from a single plan you purchase from a private insurance company.
Medicare Advantage plans frequently offer a lot of perks as well, such as health and wellness programs, member discounts, and more.
Medicare Advantage and Medicare Part D prescription drug plans are subject to change every year. Updated plan information for 2021 should become available on Oct. 1, in advance of Medicare’s Annual Election Period beginning Oct. 15. Healthline.com will provide updated 2021 plan information once it is announced by the Centers for Medicare & Medicaid Services (CMS).