Medicare coverage options

You have important decisions to make when you're eligible for Medicare. Be confident in choosing coverage that fits your health care and budget needs.

Get to know your coverage choices

Medicare coverage combinations

Key things to remember when choosing coverage

Get to know your coverage choices

When considering what Medicare coverage to choose, it's important to first understand what each option provides and who provides each. Then, we will walk through how the different options may work together to help ensure you have all the health coverage you need.

Let's review the following: Original Medicare (Parts A and B), Medicare prescription drug coverage (Part D), Medicare Advantage (Part C) and Medicare supplement insurance (Medigap).

Original Medicare (Parts A and B) is provided by the federal government. Part A helps pay for hospital stays and inpatient care, while Part B helps pay for doctor visits and outpatient care. Everyone who enrolls in Medicare gets Part A and Part B first.

Medicare Part D is prescription drug coverage. Part D coverage can be obtained from private insurance companies in one of two ways: (1) as a stand-alone Part D plan, (2) as part of a Medicare Advantage plan that includes prescription drug coverage. With either choice, the different drugs covered will vary from plan to plan.

Medicare Advantage, or Part C is an alternative way to get Part A and Part B coverage benefits. Medicare Advantage plans are "all in one" plans that are offered by private insurance companies. With Medicare Advantage plans, you still enroll in Part A and Part B through the federal government, but then you will enroll in a Part C plan with a private insurance company. Once you do that, you will get your Part A and Part B benefits through your Medicare Advantage plan. Most Medicare Advantage plans also include Part D prescription drug coverage, as well as other benefits such dental, vision, hearing and fitness. There are different types of Medicare Advantage plans, and what additional benefits are provided vary from plan to plan.

Medicare supplement insurance plans, also known as Medigap, helps pay some of the out-of-pocket costs not paid by Original Medicare (Parts A and B). There are 10 plans, organized by letters (ex. Plan A) and standardized by the federal government.* However, it’s important to note that Medigap plans are only available to purchase directly from private insurance companies. Each Medigap plan offers the same basic benefits no matter which insurance company sells it, but costs may vary.

*Note: In Massachusetts, Minnesota and Wisconsin, there are different plan options available.

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Medicare and Medigap coverage combinations

Now that we have looked at the different coverage options, let's see how some of them can be combined to provide you with more complete health care coverage.

Original Medicare, Part D and Medigap can work together. Medicare Advantage and Part D can also work together in certain situations. Medicare Advantage and Medigap cannot work together.

In total, there are seven different Medicare coverage combinations.

Original Medicare combinations

If you get Original Medicare (Parts A and B) you can choose to have only Part A and Part B, or you can add a stand-alone Part D plan, a Medicare supplement insurance (Medigap) plan or both.

Original Medicare (Part A and Part B) alone

Original Medicare (Part A and/or Part B)
PLUS a standalone prescription drug plan (Part D)

Original Medicare (Part A and Part B)
PLUS a standalone prescription drug plan (Part D)
AND a Medicare supplement (Medigap) plan

Original Medicare (Part A and Part B)
PLUS a Medicare supplement (Medigap) plan

Medicare Advantage combinations

If you choose to get your Part A and Part B benefits through a Medicare Advantage (Part C) plan, you may or may not need additional coverage. Most Medicare Advantage plans already come with built-in Part D prescription drug coverage, but some do not. You can add a stand-alone Part D plan to the following types of Medicare Advantage plans: Private-Fee-For-Service (PFFS) Medicare Advantage plan or a Medicare Medical Savings Account (MSA) plan.

Medicare Advantage plan (Part C) with included prescription drug coverage (Part D)

Medicare Advantage plan (Part C) without prescription drug coverage (Part D)

Medicare Advantage Private Fee-for-Service plan without drug coverage (Part C) OR a Medicare Savings Account (MSA) plan PLUS a stand-alone prescription drug plan (Part D)

Upbeat music plays. Text appears beside an illustrated bubble labeled "Medicare basics"

ONSCREEN TEXT: Medicare Conversations

Text appears beside an illustrated card labeled "Medicare"

ONSCREEN TEXT: Medicare basics

Karol appears sitting in a chair.

ONSCREEN TEXT: Karol Carstensen Medicare Made Clear

Hi, my name is Carol Carstensen.

NARRATOR: I'm part of the Medicare Made Clear team. And I know from trying to learn about it myself, just how much there is to know about Medicare. It can be kind of overwhelming at times, even if you've been at it for years.

Medicare card and notepad appear.

NARRATOR: So today, I'm gonna go over the basics of Medicare

because a strong foundation in the basics is gonna help you understand your choices

Karol appears again.

NARRATOR: and make better Medicare decisions for yourself.

Text appears beside a question mark icon.

ONSCREEN TEXT: What are we discussing today?

NARRATOR: We'll start at the beginning

and talk a little bit about

Karol appears again.

NARRATOR: what Medicare is and who can get it.

A bed icon appears labeled "Part A", a stethoscope icon appears labeled "Part B", a hospital bed and stethoscope icon appear labeled "Part C", and a pill bottle icon appears labeled "Part D". A hand holding a Medicare card also appears.

NARRATOR: Then, we'll talk about the parts of Medicare, what they cover, what they cost,

The icons leave the screen and the hand holding the Medicare card is left Labeled "My coverage".

NARRATOR: and then we'll go into how to put those parts together to come up with coverage that works for you.

Karol appears again.

NARRATOR: So, let's get started.

A Medicare card appears beside text.

ONSCREEN TEXT: What is Medicare?

NARRATOR: Medicare is a federal health insurance program

A cake icon appears next to a wheelchair icon.

ONSCREEN TEXT: 65+ OR 18+

NARRATOR: for people 65 and older and others who have qualifying disabilities.

The cake and wheelchair icon move to the left and a united states icon and a document icon appear.

ONSCREEN TEXT: 65+ OR 18+ Citizen Or Legal Resident

NARRATOR: You also need to be a United States citizen or a legal resident.

A blue screen appears with a dotted timeline. The last dot being a document icon labeled "Legal Resident".

ONSCREEN TEXT: at least 5 years

NARRATOR: If you're a legal resident, you need to have lived in this country for at least five years in a row, including the five years just

before you enroll in Medicare.

Karol appears again.

NARRATOR: Another important thing about Medicare is its individual insurance.

A note pad appears beside text. The note pad has three checked marks labeled "Qualify", "Enroll", and "Choose coverage".

ONSCREEN TEXT: Each person must:

NARRATOR: Meaning every individual person needs to qualify for it

themselves, enroll in it and choose coverage for themselves.

Karol appears again.

NARRATOR: This can be different from what you're used to if you've had a family health plan through an employer, for example.

A bed icon, stethoscope icon, bed and stethoscope icon, and pill bottle icon appear beside text.

ONSCREEN TEXT: What are the parts of Medicare?

NARRATOR: Government-sponsored Medicare is made up of two parts,

Bed icon appears labeled "Part A" and stethoscope icon appears labeled "Part B".

ONSCREEN TEXT: Part A and Part B. Each part covers certain health care services.

Above the icons appears text.

ONSCREEN TEXT: Original Medicare.

NARRATOR: The two together are often called Original Medicare or sometimes traditional Medicare.

A hospital bed and stethoscope icon appear labeled "Part C", a pill bottle icon appears labeled "Part D", and an umbrella icon appears labeled Medicare Supplement insurance.

NARRATOR: There's also a Part C and a Part D, and Medicare supplement insurance. And we'll get to those in a little bit.

Hospital bed icon appears labeled "Part A".

NARRATOR: So, let's start with Part A.

ONSCREEN TEXT: Hospital Insurance

NARRATOR: Part A is hospital insurance. It covers inpatient care

when you're in the hospital or a skilled nursing facility.

Hospital icon labeled "Part A" moves to the left of the screen and a note pad appears on the right. The note pad has five check marks labeled "Rooms", "Meals", "Nursing services", "Equipment", and "Operating room".

NARRATOR: It covers your room, your meals, your nursing services when

you're in the hospital, any equipment or supplies that are used in your care, operating room, whatever the needs are that you have while you're in the hospital

Karol appears again.

NARRATOR: or in a skilled nursing facility.

Stethoscope icon labeled "Part B" appears.

ONSCREEN TEXT: Medical Insurance

NARRATOR: Medicare Part B is medical insurance. It covers your doctor visits or your doctor services, even when you're in the hospital.

Stethoscope icon labeled "Part B" moves to the left of the screen and a note pad appears to the right. The note pad has 7 check marks labeled "Doctors visits & services", "Out-patient care", "Clinic visits", "Emergency room", "Ambulance", "Preventive care", and "Medical devices".

NARRATOR: Other things covered by Part B include care when you're in an outpatient facility like the clinic or the emergency room, for example,

ambulance services if you need to go to the emergency room, preventive care services like flu shots, medical devices that you might use at home,

such as a wheelchair.

Three gold coins appear beside text.

ONSCREEN TEXT: What do I pay for Medicare?

NARRATOR: Original Medicare, again, has Part A and Part B,

Karol appears again.

NARRATOR: and it does come with some costs. Those costs can include

A dollar sign icon appears labeled "Premium", a dollar bill icon appears with a dollar sign on it labeled "Deductible", and a pie chart icon appears labeled "Copay or coinsurance".

NARRATOR: premiums, deductibles, copays, and coinsurance.

Hospital bed icon appears labeled "Part A". Beside the icon is a check mark labeled "Premium", and three gold coins.

NARRATOR: Now, let's start with Part A. Part A, in fact, is premium free for most people.

ONSCREEN TEXT: Premium-free after ten years of work

NARRATOR: If you've worked and pay taxes or your spouse has for at least 10 years, then you get Part A premium free,

Karol appears again.

NARRATOR: otherwise, you would have to pay a premium.

Hospital bed icon appears labeled "Part A". Beside the icon are four check marks labeled "Premium", "Deductible", "Copay", and "Coinsurance". There are also three gold coins.

NARRATOR: Other costs for Part A include a deductible and some copays and coinsurance.

ONSCREEN TEXT: You only pay while using Part A services

NARRATOR: But importantly, you only pay for Part A when you're actually

receiving Part A services,

Karol appears again.

NARRATOR: such as when you go in the hospital.

Stethoscope icon appears labeled "Part B". Beside the icon is a check mark labeled "Premium", and three gold coins.

NARRATOR: So, Medicare Part B does come with a premium.

ONSCREEN TEXT: Premium deducted from Social Security

NARRATOR: And that will be deducted out of your Social Security check

if you receive Social Security.

Karol appears again.

NARRATOR: Otherwise, you'll need to pay it directly to Medicare.

Stethoscope icon appears labeled "Part B". Beside the icon are four check marks labeled "Premium", "Copay", "Deductible", and "Coinsurance". There are also three gold coins.

NARRATOR: Other costs with Part B include some copays, a deductible

and some coinsurance.

A pie chart appears labeled "You pay 25%".

ONSCREEN TEXT: Coinsurance

NARRATOR: For most services, you pay 20% coinsurance, and that means you pay 20% of the Medicare-approved amount

ONSCREEN TEXT: Medicare pays 80%

NARRATOR: for that service and Medicare pays 80%.

Karol appears again.

NARRATOR: So, we've talked about Original Medicare Part A and Part B, what they cover and what they cost,

Hospital bed icon labeled "Part A" and stethoscope icon labeled "Part B" appear next to four squares. The squares include a pill bottle labeled "Prescription drugs", a toothbrush labeled "Dental", eyeglasses labeled "Vision", and an ear labeled "Hearing".

NARRATOR: but they don't cover everything. Neither Part A nor Part B

covers prescription drugs, for example, dental, or vision, or hearing care.

Hospital bed and stethoscope icon labeled "Part C" and pill bottle icon labeled "Part D" appear next to four squares. The squares include a pill bottle labeled "Prescription drugs", a toothbrush labeled "Dental", eyeglasses labeled "Vision", and an ear labeled "Hearing".

NARRATOR: This is where Part C, Part D and Medicare supplement insurance come in. They offer you more coverage options.

Hospital bed and stethoscope icon labeled "Part C", pill bottle icon labeled "Part D", and umbrella icon labeled "Medigap" appear beside text.

ONSCREEN TEXT: What are these additional options?

NARRATOR: Let's start with Part C.

Hospital bed and stethoscope icon labeled "Part C" appear next to an equal sign and text.

ONSCREEN TEXT: Medicare Advantage

NARRATOR: Part C is Medicare Advantage.

Text slides over and document appears labeled "Plan 1" with text below saying, "Offered by private insurance companies".

Medicare Advantage plans are offered by private insurance companies.

ONSCREEN TEXT: Medicare Advantage

Hospital bed icon labeled "Part A" and stethoscope icon labeled "Part B" appear.

NARRATOR: They cover everything that Original Medicare covers, all of your Part A benefits and Part B benefits.

NARRATOR: In addition, most plans will include prescription drug coverage and additional benefits like dental and vision coverage.

ONSCREEN TEXT: Medicare Advantage

Hospital bed and stethoscope icon appears labeled "Part C". On the other side of the screen, it says "$0 premium" with three gold coins.

NARRATOR: The costs for a Medicare Advantage plan might include a premium or it might not. There are some plans that have $0 premiums.

Hospital bed and stethoscope icon appears labeled "Part C". Beside the icon are four check marks labeled "Copay", "Coinsurance", and "Out-of-pocket limit". There are also three gold coins.

NARRATOR: Other costs would include copays for services you receive and sometimes the coinsurance.

NARRATOR: Another important thing to know about Medicare Advantage plans

is that they are required by Medicare to set an annual out-of-pocket limit.

ONSCREEN TEXT: Out-of-pocket limit

A timeline from Jan 1 to Dec31 appears. The first part has three-dollar signs, and the next part is labeled "Plan Coverage".

NARRATOR: This out-of-pocket limit is like built-in financial protection, because if you reach that limit, the plan would pay all of your costs for the rest of that year.

ONSCREEN TEXT: There may be many plans offered and coverage may vary

NARRATOR: There may be many Medicare Advantage plans offered in a region, or a state, or a county,

Karol appears again.

NARRATOR: and each one will have its own coverage and cost terms.

Pill bottle appears beside text.

ONSCREEN TEXT: How are prescription drugs covered.

NARRATOR: Now, let's talk about Medicare Part D.

Pill bottle icon labeled "Part D" appears next to an equal sign and text.

ONSCREEN TEXT: Prescription drug coverage

NARRATOR: Medicare Part D is prescription drug coverage.

Text slides over and two lines appear pointing to a hospital bed and stethoscope icon labeled "Medicare Advantage plan" and a pill bottle labeled "Stand-alone Part D plan".

NARRATOR: You can get prescription drug coverage in two ways, either through in the Medicare Advantage plan, like we just talked about, or through a stand-alone Part D plan.

Karol appears again.

NARRATOR: You can always remember prescription drug plans and Part D by thinking D is for drugs.

A circle with many types of pills appears. Then moves to the side and a list appears labeled "Rx" with a $.

ONSCREEN TEXT: Part D coverage

NARRATOR: Medicare requires that Part D plans cover all the types or classes of drugs that are normally used by Medicare beneficiaries. Every plan has a formulary or a list of covered drugs. So, when you're choosing a Medicare Part D plan, it's really important to look at those formularies and make sure that the drugs that you take are on those lists.

Three documents appear. One labeled "Plan 1" with $, one labeled "Plan 2" with $$, and one labeled "Plan 3" with $$$.

NARRATOR: Costs for a Medicare Part D plan vary from plan to plan.

Plan 2 appears to the side and two check marks appear labeled "Premium" and "Copay". There are also three gold coins.

NARRATOR: But it usually includes a premium, and you'll probably pay a copay when you fill a prescription.

Karol appears again.

NARRATOR: What you pay in copays, again, depends on the plan and also the formulary. Every plan places certain drugs on what they call tiers,

Three lines appear labeled "Tier 3", "Tier 2", and "Tier 1" and a pill moves beside each tier.

NARRATOR: or levels, of a formulary and the level determines what you pay at the pharmacy counter. Usually, the higher the level

or tier, the more you'll pay.

Karol appears again.

NARRATOR: Costs for Medicare Part D will vary from plan to plan,

Many location bubbles appear with a pill bottle in them.

ONSCREEN TEXT: Pharmacy network Out of network

NARRATOR: but most plans have a pharmacy network. And if you fill your

prescriptions within that network, you're going to get the best price for that prescription.

A check mark appears beside text.

ONSCREEN TEXT: Can I get additional coverage?

NARRATOR: Medicare supplement insurance

is also called Medigap,

Umbrella icon labeled "Medicare supplement insurance" appear next to an equal sign and text.

ONSCREEN TEXT: Medigap

NARRATOR: and it's just what it sounds like.

Karol appears again.

NARRATOR: It supplements Medicare.

A wallet appears with a gold coin sticking out is above text.

ONSCREEN TEXT: Out-of-pocket health costs

Medicare supplement plans help pay some of the out-of-pocket costs

Karol appears again.

NARRATOR: that come with the Original Medicare Part A and Part B.

Ten documents appear each labeled "Plan" then the letter A, B, C, D, F, G, K, L, M, or N. Below the documents is text.

ONSCREEN TEXT: Medicare supplement insurance plans

NARRATOR: Medicare supplement plans are standardized, they're labeled from A through N.

Karol appears again.

NARRATOR: There's 10 different plans with

varying levels of coverage. So, each Medicare supplement plan that has the same letter offers exactly the same coverage. However, plans may differ in what they charge.

United States appear with two documents each labeled "Plan 2", but each having different amounts of dollar signs.

NARRATOR: So, a Plan G, for example, in one state may be a different price from Plan G in another state.

A hearing icon and a toothbrush icon appear beside text.

ONSCREEN TEXT: Do Medicare supplement insurance plans cover other services?

NARRATOR: The main purpose of a Medicare supplement plan is to cover the costs that come with Original Medicare Part A and Part B.

Karol appears again.

NARRATOR: However, some Medicare supplement plan providers

A note pad appears with text on it.

ONSCREEN TEXT: Medigap insurers may make value-added services available either free or on a discounted basis. These services may come from the insurer or other companies.

NARRATOR: do offer additional programs that can provide discounted

services for dental, or hearing, or other health care services.

Hospital bed, hospital bed and stethoscope, stethoscope, umbrella, and pill bottle icons appear beside text.

ONSCREEN TEXT: How do these all work together?

NARRATOR: Medicare parts and plans

Karol appears again.

NARRATOR: can work together in different combinations to offer you the coverage you need. It really comes down to two scenarios.

A bed icon appears labeled "Part A", a stethoscope icon appears labeled "Part B" below text. A plus sign with a pill bottle labeled "Part D" appears and a plus sign with an umbrella labeled "Medicare Supplement" appears.

ONSCREEN TEXT: Original Medicare

NARRATOR: You can keep Original Medicare Part A and Part B and decide to add prescription drug coverage and/or a Medicare supplement plan

ONSCREEN TEXT: Medicare Advantage plan

NARRATOR: Or you can choose a Medicare Advantage plan instead,

Hospital bed, pill bottle, toothbrush, ear, eye, stethoscope icons all appear around text.

ONSCREEN TEXT: Medicare Advantage plan

NARRATOR: which encompasses all of the coverage in one plan.

Document appears labeled "Plan 1".

ONSCREEN TEXT: Which plan is right for me?

NARRATOR: People often ask, how do I know what's right for me?

Karol appears again.

NARRATOR: What Medicare plan should I choose?

Hospital bed and stethoscope icons appear beside "Original Medicare" on top. In the middle is "Original Medicare" + pill bottle icon "Part D" + umbrella icon "Medigap". On the bottom is stethoscope/hospital bed icon "Medicare Advantage plan".

NARRATOR: Well, that choice is personal because your health needs are personal and each person needs to make a decision for themselves.

Karol appears again.

NARRATOR: There are a few things to think about as you look at Medicare plans and coverage in general.

Text appears next to a note pad with check marks labeled "Dental" and "Vision"

ONSCREEN TEXT: Medicare Advantage

NARRATOR: One, would you like to have additional benefits like dental or vision? If so, then a Medicare Advantage plan

Karol appears again.

NARRATOR: might be a better choice because they offer these options whereas Original Medicare doesn't.

Piggy bank appears labeled "Premium" with a line connecting to a wallet with a gold coin sticking out labeled "Copay".

NARRATOR: Two, would you prefer to have lower monthly premiums and pay as you go, so to speak, when you go to the doctor with the copays. Or would you prefer to have higher premiums and fewer copays or out-of-pocket expenses?

Karol appears again.

NARRATOR: Number three, do you have specific doctors

A note pad appears with a location icon labeled "Specific providers" and a plane icon labeled "Travel frequently".

NARRATOR: or providers you'd like to see, or do you travel frequently? If you do, Original Medicare might be a good choice for you

A plane goes across the screen.

NARRATOR: because every provider in the United States is covered.

ONSCREEN TEXT: Medicare Advantage plans

NARRATOR: Medicare Advantage plans often have a provider network

Many doctor icons and pill bottle appear all connected by lines.

NARRATOR: and you need to choose providers from within the network to get the plan's best prices.

Light bulb icon appears next to text.

ONSCREEN TEXT: So, what is the takeaway?

NARRATOR: So, there you have it, that's the basics of Medicare.

Karol appears again.

NARRATOR: And if there's just one thing that you take away from today, I hope it's this: you get to choose. You get to choose Medicare coverage that fits your health needs, your budget and your lifestyle.

ONSCREEN TEXT: Visit MedicareMadeClear.com

NARRATOR: If you need more information about Medicare basics or other Medicare topics, please visit us at MedicarMadeClear.com,

Karol appears again.

NARRATOR: and follow us on Facebook for answers to your Medicare questions and regular updates on Medicare topics. Thanks so much for listening.

(upbeat music)

ONSCREEN TEXT: Medicare Made Clear brought to you by UnitedHealthcare

UnitedHealthcare logo appears.

Learn more

See Medicare coverage combination examples

Get a better understanding of how each Medicare coverage combination may work, including costs, in these examples.

Four things to remember when choosing Medicare and Medigap coverage

Original Medicare (Parts A and B) comes directly from the federal government.
Medicare Part D, Medicare Advantage (Part C) and Medicare supplement insurance (Medigap) plans come from private insurance companies only.
There are seven different ways to combine Medicare coverage choices to ensure your health and budget needs are met.
Medicare Advantage and Medigap plans cannot work together.

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UnitedHealthcare pays royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers. AARP does not employ or endorse agents, brokers or producers.

AARP encourages you to consider your needs when selecting products and does not make product recommendations for individuals.

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Insured by UnitedHealthcare Insurance Company, 185 Asylum Street, Hartford, CT 06103 (available in all states/territories except ND, NY) or UnitedHealthcare Insurance Company of America, 1600 McConnor Parkway, Floor 2, Schaumburg, IL 60173 (available in AR, AZ, IL, IN, MS, NC, ND, NJ, OH, PA, SC, TN, TX, WY) or UnitedHealthcare Insurance Company of New York, 2950 Expressway Drive South, Suite 240, Islandia, NY 11749 (for NY residents). Policy Form No. GRP 79171 GPS-1 (G-36000-4).

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Medicare Advantage plans and Medicare prescription drug plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan's contract renewal with Medicare. You do not need to be an AARP member to enroll in a Medicare Advantage plan or Medicare Prescription Drug plan.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premium and/or co-payments/co-insurance may change on January 1 of each year.

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Medicare coverage options

Get to know your coverage choices

Need help finding a Medicare plan?

Medicare and Medigap coverage combinations

Original Medicare combinations

Medicare Advantage combinations

See Medicare coverage combination examples

Four things to remember when choosing Medicare and Medigap coverage

Read next: Prescriptions, providers and benefits

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