Medicare Advantage plans are all-in-one alternatives to Original Medicare, offered by private insurance companies approved by Medicare. These plans typically include hospital (Part A), medical (Part B), and often prescription drug (Part D) coverage, along with extra benefits like dental, vision, and hearing. You must still be enrolled in Medicare Part A and B to join.
Medicare Supplement plans help pay for out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. Sold by private companies, these plans offer more predictable healthcare costs and can be used with any doctor or hospital that accepts Medicare. Medigap plans do not include prescription drug coverage.
Medicare Part D plans provide coverage for prescription medications and are offered by private insurers approved by Medicare. These stand-alone plans work alongside Original Medicare or some Medicare Supplement plans to help lower the cost of your prescriptions. Each plan has its own list of covered drugs (formulary), so it’s important to choose one that fits your needs.
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Most people don’t pay a premium for Medicare Part A if they or their spouse worked and paid Medicare taxes for at least 10 years. However, Medicare Part B does have a monthly premium, which is based on your income. You may also have costs for deductibles, copayments, or if you choose additional coverage like Part C (Medicare Advantage) or Part D (Prescription Drug Plans).
Part A covers hospital stays, skilled nursing care, and hospice.
Part B covers doctor visits, outpatient care, and preventive services.
Part C (Medicare Advantage) is an all-in-one plan offered by private insurers that includes Parts A & B, and often Part D.
Part D is prescription drug coverage, also provided by private insurance companies.
Your Initial Enrollment Period (3 months before to 3 months after your 65th birthday).
The Annual Enrollment Period (October 15 – December 7 each year).
The General Enrollment Period (January 1 – March 31 if you missed initial enrollment).
Special Enrollment Periods if you lose employer coverage or qualify due to other life events.
If you have employer or union coverage, you may be able to delay Medicare without penalty. Once that coverage ends, you’ll have a Special Enrollment Period to sign up for Medicare. If you have Marketplace (ACA) coverage, you should switch to Medicare when eligible to avoid penalties or disruptions.