What is Medicare Coverage?

Medicare is a federal program designed to provide healthcare coverage to individuals aged 65 and older at a minimal cost. This program primarily consists of Original Medicare, which is divided into two parts: Part A and Part B. These parts are widely accepted by nearly every doctor and hospital across the country. Medicare Part A covers inpatient or hospital stays, while Medicare Part B addresses outpatient or medical care. Together, these two parts cover approximately 80% of the typical healthcare costs faced by seniors, leaving a few notable gaps in coverage. To help fill these gaps, many seniors consider options like Medicare Supplement Insurance and Medicare Advantage Plans for additional coverage.

Medigap, also known as Medicare Supplement Insurance, is offered by private insurance companies to address the "gaps" in Original Medicare coverage (Part A and Part B) that you would otherwise need to pay out-of-pocket. It helps cover the 20% that Original Medicare doesn't include. These Medicare Supplement Insurance plans assist with costs like deductibles, coinsurance, and copayments, and some may even cover services such as emergency care when traveling abroad. It's important to note that they do not encompass dental, vision, hearing, or prescription drugs; you will need to purchase separate Medicare Advantage Plans and pay premiums for those additional services. To qualify for a Medigap policy, you must be enrolled in both Medicare Part A and Part B, and you'll pay a monthly premium to the insurance company in addition to your Part B premium. The coverage is guaranteed renewable as long as premiums are paid, meaning your policy stays in effect year after year (CMS).

Medicare Advantage Plans (MA) are provided by private insurance companies that are approved by Medicare. Typically, these plans do not come with a monthly premium. They encompass hospital insurance (Part A) and medical insurance (Part B), with most plans also offering prescription drug coverage (Part D). Unlike Original Medicare, Medicare Advantage Plans often feature extra benefits such as dental, vision, hearing care, and even complimentary gym memberships. It's important to note that these plans are sometimes referred to as Part C and are not the same as Medicare Supplement Insurance; members usually utilize a network of contracted doctors and hospitals associated with the plan.