Coverage outside Parts A and B of Medicare

A simple primer on the parts that make up Medicare

Turning 65 is often a milestone event. For many it may mean retirement, or maybe you’re looking forward to finally claiming the Medicare benefits you’ve worked so hard for.

If you get started well before your 65th birthday, you can make sure your Medicare coverage is already there for you when you blow out the candles on your birthday cake. To help you begin on your path to your best plan, we’ve put together this simple guide to Medicare and its different parts.

Original Medicare—Part A and Part B

Original Medicare, sometimes called “traditional” Medicare, has 2 main parts:

  • Part A helps cover inpatient hospital stays, skilled nursing facility stays, some home health visits and hospice care.
  • Part B helps cover doctor’s visits and other outpatient visits and preventive services.
  • With an Original Medicare plan, you can see any doctor or visit any healthcare facility in the country that accepts Medicare.
  • What you won’t get with Original Medicare is coverage for vision, dental and hearing care. Original Medicare doesn’t include coverage for prescription drugs, either.

Medicare Advantage—Part C

If you’re looking for coverage that includes a bit more, you can opt for a Medicare Advantage plan. In 2018, nearly 34% of Medicare members chose Medicare Advantage. That’s more than 20 million people.1

Here are some of the main differences between Original Medicare and Medicare Advantage:

  • Medicare Advantage plans often cover a variety of services to help keep you healthy and not just treat you when you're sick. This may include routine vision, dental and hearing care, plus wellness services like a fitness program.
  • Some Medicare Advantage plans offer premiums as low as $0, although they may still have copayments and deductibles.
  • Medicare Advantage plans offer the security of an annual maximum out-of-pocket limit on costs, after which you pay nothing for covered services.
  • With Medicare Advantage, if you go out of your plan's network you’ll probably have to pay more. So before you sign up for a plan, it’s a good idea to make sure that the doctors and hospitals you prefer are in its network.
  • Unlike Original Medicare, some Medicare Advantage plans require a referral from your primary care doctor if you want to see a specialist.

See if your preferred doctors and hospitals participate in Humana plans

Medicare Supplement insurance

If you feel your costs for things like copayments and deductibles are too high, you can purchase a separate Medicare Supplement insurance plan to help cover out-of-pocket costs. Medicare Supplement insurance plans can only be paired with Original Medicare.

Decisions, decisions

Here’s something that may help you choose with confidence as you consider your options. Choosing a plan is not a lifelong commitment. If you want to change your plan, you’ll have the opportunity to change your plan to suit your changing needs.

Source

  1. 1. Gretchen Jacobson, Anthony Damico, and Tricia Neuman, “A Dozen Facts About Medicare Advantage,” Henry J Kaiser Family Foundation, last accessed May 3, 2019, kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage/, opens new window.

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