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Once you qualify for Medicare, you have choices.

First, you'll need to choose between Original Medicare and a Medicare Advantage plan. If you choose Original Medicare, you might also want a Medigap (Medicare Supplement insurance) plan, a prescription drug plan, or both.

Jump down the page to read about each of your options.

Original Medicare

Original Medicare is provided by the federal government. This option works the way it has since Medicare began in 1966. It includes Medicare Part A (hospitalization) coverage and Medicare Part B (doctor visit) coverage.

  • You must get services from a doctor or other health care provider that accepts Medicare.
  • Original Medicare pays 80% and you pay 20% of charges after you meet your deductible.
  • There's no annual limit on your out-of-pocket expenses. The more services you use, the more your expenses mount up.
  • You are not covered when you leave the U.S.
  • Routine checkups are not covered.
  • Prescription drug costs are not covered.

Medicare Advantage plans

Medicare Advantage plans are a replacement for Original Medicare. They are a way to get your Medicare benefits through private insurance companies that are under contract with Medicare. When you enroll in a Medicare Advantage plan you are still in the Medicare program. You still need to pay your Medicare Part B premium in addition to your Medicare Advantage plan premium.

  • These plans provide all your Medicare Part A and Medicare Part B coverage.
  • They can also offer additional benefits that Original Medicare doesn't cover, like routine checkups.
  • Costs and benefits vary between plans.
  • You save money when you go to health care providers in your plan's network.
  • Plans protect you with an annual limit on your out-of-pocket expenses.
  • You are covered worldwide for emergency and urgent care.
  • Prescription drug coverage (Medicare Part D) is included in some Medicare Advantage plans, like Priority Health's plans. These plans are called MAPD plans (Medicare Advantage + Prescription Drug).
  • Priority Health offers these plans in 31 Michigan counties.

Medigap (Medicare Supplement insurance) plans

When you have Original Medicare, you can purchase a Medigap plan from a private insurance company to help pay some of the health care costs, and it may also cover certain things, that Original Medicare doesn't cover. Medigap plans are not part of Medicare.

  • All Medigap plans are standardized nationwide. Plan A from one company will give you the same benefits as Plan A from another company.
  • Both Original Medicare and your Medigap plan will pay a portion of your covered health care costs.
  • Generally the greater the number of benefits, the more expensive the plan is.
  • The only difference in any plan from company to company is cost and customer service.
  • Medigap plans do not cover prescription drug costs.

Medicare prescription drug plans

These plans cover only Medicare Part D prescription drug benefits, helping pay for prescription drugs, insulin, some injections, and diabetic supplies used to inject insulin. They are offered by private insurance companies under contract with Medicare. These plans are often purchased by people who have Original Medicare, or both Original Medicare and a Medigap (Medicare Supplement insurance) plan.

 


Updated: May 14, 2010


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