Medicare Coverage Choices
Step 1: Enroll in Original Medicare coverage. Original Medicare is provided by the Federal Government.
Part A helps pay for hospital stays and inpatient care.
Part B helps pay for doctor visits and outpatient care.
Step 2: Decide if you need additional coverage. There are two ways to get it. (You may select Option 1 OR 2, not both)
Option 1: Medicaid Part D Plan OR Medicaid Supplement plan. (Both offered by private insurers) Medicaid Part D plan helps pay for prescription drugs. Medicaid Supplement Plan helps pay some or all of the out-of-pocket costs not paid for by Original Medicare.
-OR-
Option 2: Medicaid Advantage plan or Part C plan. (Both offered by private insurers) Part C combines Part A and Part B in one plan. Part D usually includes prescription drug coverage.
The above options provide additional benefits, services, and programs not provided by Original Medicare.
Medigap or Medicare Advantage?
Coverages
Medigap
- Pays some costs not paid by Original Medicaid
- Does not help with drug costs
- Nationwide coverage
- May offer additional value-added services
Medicare Advantage
- Provides benefits of Original Medicaid and beyond
- Often includes Part D drug coverage
- May have provider network
- May offer additional health benefits (i.e. dental, vision, hearing, etc.)
Costs
Medigap
- Monthly plan premium
- Drug plan premium and other costs if you also add a stand-alone Part D plan
- Out-of-pocket costs depend on plan chosen
Medicare Advantage
- May charge plan premium
- Often no additional premium for drug coverage
- Copays or Coinsurance for most covered services
- Annual out-of-pocket maximum
Conveniences
Medigap
- Multiple Plans (When added to Original Medicare along with a Part D plan)
Medicare Advantage
- All-in-one plan
More Resources
Visit Medicare.gov
Go to Medicare.gov now
Local Government Offices
Contact your local Social Security or State Medicaid office
Contact Your State Health Insurance Assistance Program (SHIP)
Contact phone number listed at ShipHelp.org
Call Medicare’s Hotline
1-800-MEDICARE (1-800-633-4227)
TTY: 1-877-486-2048
24 hours a day, 7 days a week