When you first sign up for Medicare Part A and Part B, Social Security automatically enrolls you in original Medicare. Original Medicare works on a fee-for-service basis. This means that you can go to any doctor or hospital that accepts Medicare, anywhere in the United States, and Medicare will pay its share of the bill for any Medicare-covered service it covers. BUT YOU PAY THE REST unless you have other insurance. There are many expenses Original Medicare does not pay.
Medicare Advantage plans (also called Medicare Part C) are offered through insurance carriers and provide the same coverage as Medicare Part A and Part B, and many also offer additional benefits at no extra cost. Most plans offer prescription drug coverage, vision, dental, & hearing. These plans could offer "0" premium, "0" copays, and much more. They are often rich in benefits and offer a Maximum Out-of-pocket amount so you know when the plan will pay 100% thereafter.
Part D plans are offered through insurance carriers. All plans must cover a wide range of prescription drugs that people with Medicare take, including most drugs in certain protected classes,” like drugs to treat cancer or HIV/AIDS. A plan’s list of covered drugs is called a “formulary,” and each plan has its own formulary. Many plans place drugs into different levels, called “tiers,” on their formularies. Drugs in each tier have a different cost. For example, a drug in a lower tier will generally cost you less than a drug in a higher tier.
If you are covered by Original Medicare, you can choose to buy private supplemental insurance (known as Medigap) to cover some of your out-of-pocket costs in the original program.
Often, these benefits are offered in a Medicare Advantage plan. If not, there are stand-alone plans through insurance carriers for dental, vision, and hearing.
You have questions about Medicare, we have the answers! There are several types of special needs plans offered through insurance carriers. These plans include Chronic Illness and Disability.
There are also Dual-eligible plans for those who are on Medicaid.