Medicare coverage includes the following options:
- Part A – Hospitalization Insurance: Benefits include: hospitalization; limited skilled nursing facility care; home health care; hospice care and blood.
- Part B – Medical Insurance: Used together with Part A, this is known as original, or traditional, Medicare. Benefits include: medically-necessary doctors’ services; outpatient medical; hospital and surgical services; clinical laboratory services; home healthcare; blood and various preventive services such as flu shots and mammograms.
- Part C – Medicare Advantage: Part C offers an alternative to Parts A and B. These plans are offered by private insurance companies that contract with Medicare to provide all Medicare Part A and Part B benefits. At a minimum, these plans cover all Medicare Part A and B services. In most cases, there are extra benefits and lower co-payments than in the original Medicare plan. In addition, most Medicare Advantage Plans offer prescription drug coverage.
- Part D – Prescription Drug Coverage: Coverage includes both brand-name and generic prescription drugs. Part D plans are run by private companies that are approved by Medicare. Part D coverage is optional and available to those enrolled in traditional Medicare (Parts A and B) or in Medicare Advantage plans that do not offer prescription drug coverage.
- Medigap for Parts A and B: Also known as Medicare Supplement insurance, these policies are sold by private insurance companies that fill the “gaps” in traditional Medicare coverage. An example of a gap would be the 20 percent co-payment due on a Medicare Part B claim for a visit to the doctor. Medigap coverage is only available to those enrolling in traditional Medicare, Parts A and B.
When it comes time to enroll, the first decision you will need to make is whether to go the traditional Medicare coverage route with Parts A and B, or to go with a Medicare Advantage, or Part C, plan.
Those choosing traditional Medicare, Parts A and B, will need to add prescription drug coverage by enrolling in either a Part D plan or a Medigap plan that includes drug coverage. An alternative to traditional Medicare would be to select a Medicare Advantage, Part C, plan, which can provide prescription drug coverage in addition to hospitalization and medical coverage.
Content for this section provided by Allsup, Inc. and Mark Rubin, J.D.