When you first enroll in 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 and Medicare Advantage (also known as Part C).
- Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.
- Some plans may have lower out-of-pocket costs than Original Medicare.
- Some plans offer extra benefits that Original Medicare doesn’t cover— like vision, hearing, or dental.
Doctor and hospital choice
- In most cases, you’ll need to use doctors who are in the plan’s
network (for non-emergency or non-urgent care). Ask your doctor if they participate in any Medicare Advantage Plans.
- You may need to get a referral to see a specialist.
- Out-of-pocket costs vary—some plans have low or no out-of-pocket costs.
- You may pay a premium for the plan (most include prescription
drug coverage) and a premium for Part B. Some plans have a $0 premium or will help pay all or part of your Part B premium.
- Plans have a yearly limit on what you pay out-of-pocket for Medicare Part A and B covered services. Once you reach your plan’s limit, you’ll pay nothing for Part A- and Part B-covered services for the rest of the year.
- You can’t buy or use separate supplemental coverage—but some plans have lower out-of-pocket costs than Original Medicare.
- Plans must cover all of the services that Original Medicare covers. Some plans offer extra benefits that Original Medicare doesn’t cover— like vision, hearing, or dental.
- Prescription drug coverage is included in most plans.
- In some cases, you have to get a service or supply approved ahead of time for it to be covered by the plan.
- Plans usually don’t cover care outside the U.S. Also, plans usually don’t cover non-emergency care you get outside of your plan’s network.