Things to Consider When Choosing Medicare Coverage

Topics on Medicare coverage.

Original Medicare
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Medicare Advantage
There is no limit on how much you pay out-of-pocket per year unless you have supplement coverage.
Cost
Plans have a yearly limit on your out-of-pocket costs. If you join a Medicare Advantage Plan, once you reach a certain limit, you will pay nothing for covered services for the rest of the year.
Medicare covers medical services and supplies in hospitals, doctors’ offices, and other healthcare settings. Services are either covered under Part A or Part B.
Coverage*
Plans must cover all of the services that Original Medicare covers. Plans may offer benefits that Original Medicare does not cover vision, hearing, or dental.
You can add a Medigap policy to help pay your out-of-pocket costs for Original Medicare, like your deductible and coinsurance.
Supplement
coverage
It may be more cost-effective for you to join a Medicare Advantage Plan because your cost sharing is lower (or included). You can’t use (and can’t be sold) a Medigap policy if you are in a Medicare Advantage Plan
You will need to join a Medicare Prescription Drug Plan to get drug coverage.
Prescription
drugs*
Most Medicare Advantage Plans include drug coverage.
You can go to any doctor that accepts Medicare.
Doctor and Hospital
choice
You may need to use health care providers who participate in the plan’s network. If so, find out how close the network’s doctor or pharmacies are to your home. Some plans offer out-of-network coverage.
You can get a snapshot of the quality of care health care providers (and facilities) give their patients by visiting Medicare.gov.
Quality of Care
The Medicare Plan finder at Medicare.gov/find-a-plan features a star rating system for Medicare plans.
Original Medicare generally doesn’t cover care outside the U.S. You may be able to buy supplemental insurance that offers travel coverage.
Travel
Plans usually don’t cover care you get outside the U.S.

*If you have other types of health or prescription drug coverage, check to see how it works with the type of coverage you are considering before you make any decisions or changes.