window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'G-TMSRFZZYSF');

What services does Medicare cover??

Medicare Part A and Part B cover certain medical services and supplies in hospitals, doctors’ offices, and other health care settings. Prescription drug coverage is provided through Medicare Part D.

Solving the Mysteries of Medicare

Lesson 2: Medicare Advantage

Medicare Advantage

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 

  • 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.

Cost

  • 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.

Coverage 

  • 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.

Travel

  • 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.
This website uses cookies and third party services. Ok