Medicare: What You Need to Know
Understanding the basics of Medicare, how it works, and what it covers. Essential knowledge for making informed healthcare decisions.
Medicare Education
Medicare Simplified
Understanding your Medicare choices doesn't have to be complicated. Explore your coverage options and make informed decisions about your healthcare.
Medicare offers multiple coverage options to meet your healthcare needs. Whether you're new to Medicare or reviewing your current coverage, understanding the differences between Original Medicare, Medicare Advantage, and supplemental coverage is key to making the right choice.
Medicare Coverage Topics
Explore the different types of Medicare coverage and find what works best for you.
Medicare Advantage Plans
All-in-one alternatives to Original Medicare offered by private insurers. Often includes Part D drug coverage and extra benefits like dental and vision.
Medicare Supplement (Medigap)
Supplemental insurance that helps pay for costs Original Medicare doesn't cover, such as copayments, coinsurance, and deductibles.
Part D Prescription Drug Plans
Coverage for prescription medications. Available as standalone plans or included with Medicare Advantage. Helps reduce your out-of-pocket drug costs.
Medicare Eligibility
Learn when you qualify for Medicare, how to enroll, and important deadlines to avoid late enrollment penalties.
Types of Medicare Advantage Plans
Compare HMOs, PPOs, PFFS, and SNPs. Understanding plan types helps you choose the right coverage for your healthcare needs.
Medicare Supplement Plan Comparison
Medigap plans are standardized by letter. Here's a quick overview of what each plan covers.
Plan
Coverage Summary
Plan A
Basic benefits
Plan B
Basic + Part A deductible
Plan C
Comprehensive (not available to new enrollees after 2020)
Plan D
Similar to C without Part B excess charges
Plan F
Most comprehensive (not available to new enrollees after 2020)
Plan G
Similar to F without Part B deductible coverage
Plan K
50% cost-sharing with out-of-pocket limit
Plan L
75% cost-sharing with out-of-pocket limit
Plan M
Similar to D with 50% Part A deductible
Plan N
Similar to D with copays for some visits
Note: Plans C and F are only available to those who became eligible for Medicare before January 1, 2020.
Frequently Asked Questions
Common questions about Medicare coverage options
What is Medicare Advantage?
Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare offered by private insurance companies. These plans include Part A (hospital) and Part B (medical) coverage, and usually Part D (prescription drugs). Many plans offer extra benefits like dental, vision, hearing, and fitness programs.
How do I choose between Medicare Advantage and Medigap?
The choice depends on your healthcare needs and budget. Medicare Advantage often has lower premiums and includes extra benefits, but typically requires using network providers. Medigap supplements Original Medicare, giving you more provider freedom but usually at a higher premium. Consider your doctors, medications, and travel needs when deciding.
When can I enroll in Medicare Supplement insurance?
The best time to enroll is during your 6-month Medigap Open Enrollment Period, which starts the month you turn 65 and are enrolled in Part B. During this period, insurers cannot deny you coverage or charge more due to health conditions.
Do I need Part D if I have Medicare Advantage?
Most Medicare Advantage plans include prescription drug coverage (Part D). If your plan includes drug coverage, you don't need a separate Part D plan. However, if your MA plan doesn't include drug coverage and you need prescriptions, you should enroll in a standalone Part D plan.
What's the difference between HMO and PPO Medicare Advantage plans?
HMO plans typically require you to use in-network providers and get referrals for specialists. PPO plans offer more flexibility - you can see out-of-network providers (though at higher cost) and usually don't need referrals. PPO plans often have higher premiums than HMOs.
Can I switch Medicare plans?
Yes, you can make changes during the Annual Enrollment Period (October 15 - December 7) each year. If you have Medicare Advantage, you can also make one change during the Medicare Advantage Open Enrollment Period (January 1 - March 31). Special Enrollment Periods may apply in certain circumstances.
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