Understanding Your Options

Original Medicare is a federal program that covers hospital (Part A) and medical services (Part B). It provides essential healthcare coverage, but it doesn’t include prescription drug coverage, dental, vision, or hearing care.
 

• Broad acceptance among doctors and hospitals across the U.S.
   
• No need to select a primary care doctor or get referrals.
   
• You can add a separate Part D plan for prescription drug coverage.
  
• You must pay deductibles and coinsurance.
   
• No coverage for prescription drugs, dental, vision, or hearing unless you add additional plans.
   
• No cap on out-of-pocket costs.
  
   

Medicare Advantage plans are offered by private insurers approved by Medicare. These plans bundle the benefits of Parts A, B, and often include Part D (Prescription Drug Coverage), with extra benefits like dental, vision, and hearing care. They can also provide lower out-of-pocket costs compared to Original Medicare. Medicare Advantage vs Medicare is an interesting discussion, because you still retain your Original Medicare benefits in if you enroll in the Medicare Advantage program. Schedule a consultation to learn more.
 

• All-in-one coverage (hospital, medical, and often prescription drugs).
   
• Additional benefits like dental, vision, and hearing.
   
• Often lower premiums compared to Original Medicare with Part D.
   
• Limits out-of-pocket costs through an annual Maximum Out-of-Pocket (MOOP).
  
• You must use a network of doctors and hospitals, unless you choose an out-of-network (OON) plan which may have higher costs for OON providers.
   
• Plans may change annually, meaning coverage or costs could vary each year.
   

Medigap plans are Medicare policies that are sold by private insurance companies and work alongside Original Medicare to help cover costs not paid by Medicare, such as deductibles, co-insurance, and co-payments. Medigap plans are one of a few Medicare options, but do not cover prescription drugs, so you’ll need Part D for that.

• Helps cover gaps in Original Medicare, reducing out-of-pocket costs.
   
• Predictable costs with a set monthly premium and coverage limits.
   
• No networks—you’re covered by any provider who accepts Medicare.
  
• Only available if you have Original Medicare (Parts A & B).
   
• Can be expensive, with premiums varying depending on the plan and location.
   
• Doesn’t include prescription drug coverage (you must buy a separate Part D plan).
   

Part D includes standalone prescription drug plans that can be added to Original Medicare (Parts A and B). These Medicare policies provide coverage for prescription medications only, and help to reduce out-of-pocket costs for medications you need.

• Provides coverage for prescription medications not included in Original Medicare.
   
• Available to anyone with Part A and/or Part B.
   
• Helps lower prescription drug costs.
  
• Monthly premiums vary depending on the plan.
   
• The formulary (list of covered drugs) varies by plan.