Plans insured by Aetna Health and Life Insurance Company, an Aetna Company

How does
Medicare work?

Overview

Medicare has four parts:

Part A (hospital insurance)
Part B (medical insurance)
Part C is called Medicare Advantage
Part D covers prescription drugs.

Medicare continued

Medicare Parts A and B.

Medicare Parts A and B are often referred to as Original Medicare. They are managed by the federal government.

Medicare Parts C and D.

Part C, or Medicare Advantage, combines Medicare Parts A and B, and sometimes Part D. Medicare Advantage plans are regulated by the federal government and sold by private insurance companies.

Prescription Drug Coverage

Part D (Prescription Drug Coverage)
  • Covers your prescription drugs
  • Can be purchased separately to go with Original Medicare (Parts A & B)
  • May be included in a Medicare Advantage plan
  • Generally, monthly premium for standalone Part D coverage, in addition to your Part B premium

Original Medicare:

Part A (Hospital Insurance)
  • Inpatient hospital and rehabilitation facility care, including X-rays, surgeries and radiation treatment
  • Skilled nursing facility, hospice and home health care
  • Most people won’t pay a premium for Part A

Original Medicare Continued:

Part B (Medical Insurance)
  • Outpatient hospital and home health care
  • Ambulance, doctor and preventive services
  • You’ll pay a monthly premium for Part B (usually deducted from your Social Security check)

Medicare Advantage

Part C (Medicare Advantage)
  • Covers all your Parts A and B benefits
  • May cover your prescription drugs, too
  • May also offer extra benefits like vision or dental coverage or a fitness membership
  • May require you to see network doctors or specialist
  • Caps your out-of-pocket spending to protect your finances
  • You may pay a monthly premium for Part C and you must keep paying your Part B premium

Medicare Supplement Insurance

Medicare Supplement Insurance, also called Medigap

Medicare Supplement Insurance, also called Medigap, can be purchased to help cover out-of-pocket costs that Medicare Parts A and B don’t cover, like copayments, coinsurance and deductibles. Medigap Insurance is sold by private insurance companies.

When do I enroll in Medicare?

Your Initial Enrollment Period (IEP) is seven months long and includes the month you turn 65 as well as the three months before and after.

Once your IEP ends, you may have the chance to sign up for Medicare during a Special Enrollment Period. Speak to a licensed Medicare producer/agent to learn more about your enrollment options.

So, what's the difference?

The difference between Medicare Supplement and Medicare Advantage is that both plans add coverage, but in different ways. In each plan, you’ll be expected to continue to pay your Part B premium.

The breakdown

Medicare Supplement Insurance

  • Helps cover the out-of-pocket costs Original Medicare doesn't pay, like copays, coinsurance and deductibles.
  • You must already have Medicare Part A & Part B and keep paying your monthly Medicare Part B premium.
  • Massachusetts, Minnesota and Wisconsin have set up their plans differently. (Ask your producer/agent about important plan differences in these states.)
  • Premiums depend on your age, where you live, the insurer and the type of plan you select.
  • All plans are guaranteed renewable, as long as you pay your premium.

Medicare Advantage

  • Required to provide all the benefits of Original Medicare Part A & B and may provide additional coverage and benefits.
  • Must continue to pay your Medicare Part B premium and sometimes, a monthly premium for the plan.
  • May require you to use providers within a network or charge more for using providers outside a network.
  • May require you to pay copays, coinsurance and deductibles
  • Limits your annual out-of-pocket costs on covered medical services
  • May change each year
  • May include prescription drug coverage (Part D)
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