Understanding Your Medicare Options
- Inpatient Hospital Care
- Skilled Nursing Facility Care
- Nursing Home Care (inpatient care in a skilled nursing facility that is not custodial or long-term care)
- Hospice Care
- Home Health Care
- Clinical Research
- Ambulance Services
- Durable Medical Equipment (DME)
- Mental Health
- Inpatient
- Outpatient
- Partial Hospitalization
- Durable Medical Equipment (DME)
- Limited Outpatient Prescription Drugs
Original Medicare (Part A & Part B) pays for much, but not all, of the cost for covered healthcare services. That's where Part C comes in to help with copayments, coinsurance and deductibles.
There are two main types of Part C coverage options: Medicare Advantage Plans and Medicare Supplement Plans.
Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are an “all in one” alternative to Original Medicare. They are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. These "bundled" plans include Medicare Part A, Part B, and usually Medicare drug coverage (Part D).
Click here to read more about Medicare Advantage Plans on Medicare.gov
Medicare Supplement Insurance (also known as "Medigap") helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Plan can help pay some of the remaining health care costs, like:
- Copayments
- Coinsurance
- Deductibles
Click here to read more about Medicare Supplement Plans on Medicare.gov
If you have a Medicare Advantage (MA) plan, you may already have this built-in coverage for prescription drugs. However, if you choose to buy a Medicare Supplement plan, you will also need to buy a standalone Prescription Drug Plan (PDP).
All PDP plans must cover a wide range of prescription drugs that people with Medicare take, including most drugs in certain protected classes,” like drugs to treat cancer or HIV/AIDs.
PDPs are sold by insurance carriers, and each PDP has its own list of covered drugs called a Formulary. Usually, most PDPs place drugs into different levels called “tiers” on their formularies. Drugs in each tier have a different cost. For example, a drug in a lower tier will generally cost you less than a drug in a higher tier.
When searching for the best PDP plan to meet your needs, consider your current medications; they will play a key role in finding the best PDP to meet your unique healthcare needs.