Type of Plan: Original Medicare
(Part A and Part B)
Description: Helps cover your medical services and hospitalization, but not most outpatient Medicare prescription drugs, vision or hearing.
- Medicare (the federal government) provides this coverage
- You have your choice of doctors
- Generally, Medicare Part B covers 80% of covered costs and you pay 20% after meeting your deductible
Might be a good choice if: You simply need basic medical and hospital benefits, without coverage for prescription drugs or extras such as wellness care and vision. If you choose Original Medicare and want prescription drug coverage, you will need to enroll in a stand-alone prescription drug plan.
Type of Plan: Medicare Advantage Plans
Description: A Medicare Advantage plan (like an HMO, PPO or PFFS) covers the same services as Original Medicare plus additional benefits such as wellness care, vision and/or hearing coverage. You can add prescription drug coverage by enrolling in a Medicare Advantage plan with Medicare prescription drug coverage ("MAPD" plan). If you are enrolled in a Private Fee-for-Service (PFFS) plan without Medicare prescription drug coverage, you can also add Medicare prescription drug coverage by enrolling in a stand-alone prescription drug plan.
Generally, Medicare Advantage plans:
- Are offered by private companies such as Aetna
- May have copays, deductibles, and/or coinsurance for covered services
- Have costs and extra benefits that may vary by plan
- May either require you to see doctors in their network or let you choose
Might be a good choice if: You want more complete coverage and benefits than what is covered by Original Medicare. Think of Medicare Advantage with prescription drug coverage as an all-in-one plan. It's the only option that includes hospital, medical and prescription drug coverage with one ID card and one monthly plan premium (in addition to your Part B premium and Part A premium, if applicable).
Type of Plan: Medicare Rx Plans
Description: Covers Medicare Part D outpatient prescription drugs.
- You can get prescription drug coverage included as part of a Medicare Advantage plan (“MAPD”), usually for an extra cost
- If you have Original Medicare, Medicare Supplement, or a Private Fee-for-Service plan without prescription drug coverage, you can choose a stand-alone Medicare Rx (prescription drug) plan that is offered by a private company such as Aetna. You may have to pay an additional monthly plan premium.
Might be a good choice if: You currently take prescription drugs or may need to take them in the future. It makes sense to be covered, because you never know when you might need medication. And if you don't join a prescription drug plan when you first become eligible. You also will avoid any possible late enrollment penalties.
Don’t take many prescription medications? You should still consider enrolling in a plan today. Even if you don’t take a lot of prescription drugs now, joining a Medicare Rx plan helps ensure you have coverage if the need should unexpectedly arise and you will avoid any possible late enrollment penalties.
Type of Plan: Medicare Supplement (or Medigap) Plans
Description: A non-network plan that pays after Original Medicare and lets you choose your doctors and hospitals.
- If you have Original Medicare, you can choose to buy this private supplemental coverage
- Costs vary by company and policy
- Plans cannot be changed or canceled if you relocate to a different state
- This coverage is not needed or available with Medicare Advantage plans
- You can also enroll in a standalone Medicare Part D prescription drug plan for an additional monthly plan premium.
Might be a good choice if: You want coverage for Original Medicare (Parts A and B) out-of-pocket costs, such as deductibles and coinsurance, and visit the doctors and hospitals of your choice. Also if you want to keep your plan even if you move.
