Page 6 - MedicareBookPresentation
P. 6
Choice1: Original YOUR OBJECTIVE..... Choice 2: Insurance carriers design
Medicare [Part A + Part Select one of two choiSceesctbioenlo1w —.... .LearnthHeoswe pMlaends,icgaertethWemorakpsprov1e7d
B] + Part D Prescription from CMS annually and sell them to
Drugs Plan + Medicare the eligible candidates of age above
Supplement Insurance 65. Medicare pays fixed premiums
What are my Medicare coveragtoecacrhrieorsic, tehes?carriers control and
(Medigap) policy by
private insurance administer these plans.
carriers. There are 2 main choices for how you get your Medicare coverage.
Use these steps to help you decide.
Choice 1 Choice 2
Decide if you want Original Medicare or a Medicare Advantage Plan.
Original Medicare Medicare Advantage
includes Part A (Hospital Insurance) (Part C) includes BOTH Part A (Hospital
and/or Part B (Medical Insurance) Insurance) and Part B (Medical Insurance)
■■Medicare provides this coverage directly. ■■Private insurance companies approved by
■■You have your choice of doctors, hospitals, Medicare provide this coverage.
and other providers that accept Medicare. ■■In most plans, you need to use plan doctors,
■■Generally, you or your supplemental hospitals, and other providers or you may pay
coverage pay deductibles and coinsurance. more or all of the costs.
■■You usually pay a monthly premium for ■■You may pay a monthly premium (in
Part B. addition to your Part B premium), deductible,
See pages 75–82. copayments, or coinsurance for covered
services.
Step 2 ■■Costs, extra coverage, and rules vary by plan.
See pages 83–98.
Decide if you want prescription
drug coverage (Part D). Step 2
■■If you want drug coverage, you must join Decide if you want prescription
a Medicare Prescription Drug Plan. You drug coverage (Part D).
usually pay a monthly premium.
■■If you want drug coverage, and it’s offered
■■These plans are run by private companies by your Medicare Advantage Plan, in most
approved by Medicare. cases, you must get it through your plan.
See pages 105–118. ■■In some types of plans that don’t offer
drug coverage, you can join a Medicare
Step 3 Prescription Drug Plan.
Decide if you want See page 105.
supplemental coverage.
■■You may want to get coverage that fills Note: If you join a Medicare Advantage Plan,
gaps in Original Medicare coverage. You you can’t use Medicare Supplement Insurance
can choose to buy a Medicare Supplement (Medigap) to pay for out-of-pocket costs you have
Insurance (Medigap) policy from a private in the Medicare Advantage Plan. If you already
company. have a Medicare Advantage Plan, you can’t be
sold a Medigap policy. You can generally only
■■Costs vary by policy and company. use a Medigap policy if you disenroll from your
■■Employers/unions may offer similar coverage. Medicare Advantage Plan and return to Original
See pages 99–104. Medicare. See page 103.
In addition to the options listed above, you may be able to join other types of Medicare health plans.
See pages 90–98. Some people may have other coverage like employer or union, Medicaid, TRICARE, or
veterans’ benefits. See pages 116–118.
Medicare [Part A + Part Select one of two choiSceesctbioenlo1w —.... .LearnthHeoswe pMlaends,icgaertethWemorakpsprov1e7d
B] + Part D Prescription from CMS annually and sell them to
Drugs Plan + Medicare the eligible candidates of age above
Supplement Insurance 65. Medicare pays fixed premiums
What are my Medicare coveragtoecacrhrieorsic, tehes?carriers control and
(Medigap) policy by
private insurance administer these plans.
carriers. There are 2 main choices for how you get your Medicare coverage.
Use these steps to help you decide.
Choice 1 Choice 2
Decide if you want Original Medicare or a Medicare Advantage Plan.
Original Medicare Medicare Advantage
includes Part A (Hospital Insurance) (Part C) includes BOTH Part A (Hospital
and/or Part B (Medical Insurance) Insurance) and Part B (Medical Insurance)
■■Medicare provides this coverage directly. ■■Private insurance companies approved by
■■You have your choice of doctors, hospitals, Medicare provide this coverage.
and other providers that accept Medicare. ■■In most plans, you need to use plan doctors,
■■Generally, you or your supplemental hospitals, and other providers or you may pay
coverage pay deductibles and coinsurance. more or all of the costs.
■■You usually pay a monthly premium for ■■You may pay a monthly premium (in
Part B. addition to your Part B premium), deductible,
See pages 75–82. copayments, or coinsurance for covered
services.
Step 2 ■■Costs, extra coverage, and rules vary by plan.
See pages 83–98.
Decide if you want prescription
drug coverage (Part D). Step 2
■■If you want drug coverage, you must join Decide if you want prescription
a Medicare Prescription Drug Plan. You drug coverage (Part D).
usually pay a monthly premium.
■■If you want drug coverage, and it’s offered
■■These plans are run by private companies by your Medicare Advantage Plan, in most
approved by Medicare. cases, you must get it through your plan.
See pages 105–118. ■■In some types of plans that don’t offer
drug coverage, you can join a Medicare
Step 3 Prescription Drug Plan.
Decide if you want See page 105.
supplemental coverage.
■■You may want to get coverage that fills Note: If you join a Medicare Advantage Plan,
gaps in Original Medicare coverage. You you can’t use Medicare Supplement Insurance
can choose to buy a Medicare Supplement (Medigap) to pay for out-of-pocket costs you have
Insurance (Medigap) policy from a private in the Medicare Advantage Plan. If you already
company. have a Medicare Advantage Plan, you can’t be
sold a Medigap policy. You can generally only
■■Costs vary by policy and company. use a Medigap policy if you disenroll from your
■■Employers/unions may offer similar coverage. Medicare Advantage Plan and return to Original
See pages 99–104. Medicare. See page 103.
In addition to the options listed above, you may be able to join other types of Medicare health plans.
See pages 90–98. Some people may have other coverage like employer or union, Medicaid, TRICARE, or
veterans’ benefits. See pages 116–118.
