Medicare coverageWhat does Medicare cover? Learn about DME coverage options
When it comes time to sign up for Medicare, you face a choice: Do you choose Original Medicare, combine it with a Medicare Supplement plan, or do you sign up for a Medicare Advantage plan?
About two-thirds of people choose Original Medicare, while one-third choose Medicare Advantage plans,1 which are growing in popularity. The right choice for you will depend on your unique needs.
How Original Medicare works
With Original Medicare, you are free to see any doctor who accepts Medicare patients, with no referrals required. You typically pay a deductible and coinsurance for Original Medicare Parts A and B.2
- Medicare Part A helps cover hospital care, skilled nursing facilities, and some home health services. Most people who paid Medicare taxes while working usually don’t pay a monthly premium for Part A.3
- Medicare Part B helps cover services including doctor’s visits and preventive services. Most people pay an average of $109 to $134 a month for this coverage, deducted from their Social Security payments. Higher-income earners pay more.4
Medicare Part D helps cover prescription drug costs. Costs for Part D depend on things like the plan you choose and what type of prescription drugs you require.5
Medigap or Medicare Supplement plans can help pay costs that Medicare doesn’t, including copays, deductibles and co-insurance. Costs vary by the state you live in and the plan you choose.6
How Medicare Advantage plans work
Medicare Advantage plans (also known as Medicare Part C) combine doctor, hospital and often drug coverage into one plan. Some may cover routine dental, vision and hearing needs, and may offer other services.
Most Medicare Advantage plans offer prescription drug coverage. Medicare Advantage plans usually have copays and deductibles, but many limit the total amount you will have to pay for medical expenses out of pocket each year.7
Many Medicare Advantage plans are health maintenance organization (HMO) or preferred provider organization (PPO). If you have an HMO, you can only visit doctors and hospitals in those networks. PPO plans have out-of-network benefits as well. Visits to a specialist often require referrals, and some types of care may require advance approval.7
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