Medicare is federal health insurance, generally for people age 65 or older and for some younger people with qualifying disabilities or conditions. Your coverage path may combine different parts and private insurance products.
Original Medicare
Original Medicare is administered by the federal government. Part A generally helps cover inpatient hospital care, skilled nursing facility care, hospice, and certain home health services. Part B generally helps cover physician services, outpatient care, preventive services, and certain medical equipment.
Medicare Advantage
Medicare Advantage plans are offered by private companies approved by Medicare. They provide Part A and Part B benefits and often include Part D prescription coverage. Plans may also offer extra benefits, but networks, service areas, rules, and out-of-pocket costs vary.
Medicare Supplement insurance
Medicare Supplement policies—often called Medigap—are sold by private insurance companies and work with Original Medicare. They can help pay certain deductibles, coinsurance, and copayments. They do not replace Original Medicare and generally do not include outpatient prescription coverage.
Prescription drug coverage
Part D coverage is available through private plans approved by Medicare. It may be purchased as a stand-alone plan with Original Medicare or included in many Medicare Advantage plans. Each plan has a formulary and cost-sharing structure that can change from year to year.
The best fit lives in the details.
- Enrollment timing and eligibility
- Monthly premiums and possible out-of-pocket costs
- Doctors, hospitals, and provider networks
- Prescriptions, formularies, and pharmacies
- Travel or multi-state coverage needs
- Referrals, prior authorization, and plan rules