Medicare for You: What You Need to KnowReading Time: 2 Minutes
Last Updated: April 6, 2023
We invited the Administrator to share helpful information on Medicare coverage. This is part 1 in the two-part series.
Your health is important and needs to be protected. If you are 65 or older, or have certain disabilities, or End-Stage Renal Disease, you can get health care coverage through the Medicare program. You’ll get access to health care services you need to achieve and maintain good health.
It’s important to review your Medicare coverage options and find an affordable option that meets your health care needs.
Medicare coverage options
There are two types of Medicare coverage:
- Traditional or Original Medicare.
- Medicare Advantage.
Original Medicare helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care. It also covers:
- Services from doctors and other health care providers.
- Outpatient care.
- Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment).
- Preventive services (like screenings, certain vaccines, and annual wellness visits).
Original Medicare is often referred to as Part A and Part B. You can go to any doctor or hospital, anywhere in the United States, that accepts Medicare. If you have Original Medicare, you can also buy a Medicare Supplement Insurance (Medigap) policy from a private insurance company. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medigap policy can help pay some of the remaining health care costs, such as copayments, coinsurance, and deductibles.
Medicare Advantage bundles your Original Medicare – and usually Medicare prescription drug coverage – into one health insurance plan. If you select Medicare Advantage coverage, you join a plan offered by Medicare-approved private companies.
Each plan can have different rules for how you get services – like referrals to see a specialist. All plans must cover emergency and urgent care, as well as all medically necessary services covered by Original Medicare.
In many cases, you can only use doctors and other providers who are in your plan’s network and service area. Costs for monthly premiums and services vary depending on which plan you join. Some plans may offer some extra benefits that Original Medicare doesn’t cover — like vision, hearing, and dental services.
Whether you choose Original Medicare or Medicare Advantage, be sure you have prescription drug coverage. You can join a Medicare Prescription Drug Plan (called a PDP) in addition to Original Medicare. You can also get it by joining a Medicare Advantage plan with Medicare prescription drug coverage.
Please visit Medicare.gov to learn more about the difference between Original Medicare and Medicare Advantage. With the Medicare Plan Finder, you can see comparisons of costs and coverage for Original Medicare, Medicare Advantage, and Medicare drug plans.
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