The most recent news and information about Coronavirus (COVID-19)
The most recent news and information about Coronavirus (COVID-19)
Covers hospital and nursing home stays. and hospice care.
Covers doctor services, outpatient hospital care, durable medical equipment, and other medical services.
Coverage limitations apply. Learn more about coverage gaps and the cost of Medicare »
Insurance offered by Medicare-approved private companies to provide all the benefits of Part A and Part B plus additional things that Medicare doesn't cover.
All the Benefits of parts
A + B Plus:
* Prescription Drug Coverage
Many Medicare Advantage plans cover prescription drugs within their plans. Some do not offer this service. Check the details of each plan to see whether or not prescription drugs are covered in the policy.
Benefits displayed above are for example purposes only. Actual benefits vary by plan.
Private companies who offer Medicare Advantage plans usually offer a number of different plan options to suit your individual health and financial needs. You are free to choose any type of Medicare Advantage plan you want from any insurance company that is available in your area.
Patients select a primary care physician (PCP) from within the network, and referrals to specialists go through your PCP.
No network restrictions or referrals; premiums may be higher.
The plan determines how much it will pay and how much you must pay for care. Not all providers may accept the plan’s payment terms. Also, if your plan has a network, you may pay more to see an out-of-network provider.
Additional Coverage - Medicare Advantage plans typically cover vision, hearing, and health and wellness programs.
Filling Cost Gaps - Covers the cost of care that may fall outside the established scope or time frame of Original Medicare.
Managed Care - Our HMO plan offerings offer coordinated care within a network of care providers.
Filling the Medicare Gap »
Insurance offered by Medicare-approved private companies to cover the cost of prescription drugs for anyone who has Part A, Part B or Part C (if the Part C plan does not already include prescription drug coverage.)
As part of a Medicare Advantage Plan (Part C)
Your Medicare Advantage plan must include prescription drug coverage. (Some Medicare Advantage plans do not include prescription drugs.)
As a standalone add-on to Original Medicare (Parts A & B)
Standalone add-on plans include Medicare Cost plans, Medicare Private Fee-for-Service plans and Medicare Medical Savings Account plans.
You cannot have both of these plan options at the same time. If you do, you will be dis-enrolled in your Medicare Advantage plan (Part C) and returned to Original Medicare (Parts A & B.)
These plans typically do not include prescription options, so you can join a stand-alone drug plan if you enroll in a PFFS plan.
These plans typically do include prescription options, and require you to get your Medicare prescription drug benefits through the plan.
If you do not enroll in Medicare Part D when you first become eligible for Medicare you may pay a penalty if you need to enroll in Part D a later time. The penalty is applied to your Medicare Part D premium after your initial enrollment period has ended and you’ve gone 63 consecutive days without either Medicare Part D coverage or some other form of creditable prescription drug coverage. Creditable prescription drug coverage is alternate drug coverage (often through an employer or union) that covers the same prescription drug costs as standard Medicare Part D prescription drug coverage.
Regardless of how you elect to receive your Medicare Part D coverage, or which insurance provider you choose, there are coverage limitations and gaps that exist. The "Donut Hole" is one of these gaps, but it's proper name is actually the "Coverage Gap Stage".
There are a number of different options you can choose from when considering your Medicare insurance coverage. These options are best described by looking at a number of coverage scenarios.