Medicare Quick Facts Sheet
Medicare consists of three parts: A, B, & D. Part A is hospital/inpatient coverage. Part B is doctor/outpatient coverage. Part D is your prescription drug coverage, which is actually obtained through private insurance companies. The coverage provided by the government, Part A and Part B, are not comprehensive coverage. If you just have these two parts as your only health insurance, you could potentially have thousands of dollars that you must pay out of pocket per year! For this reason, many people take out a Medicare Supplement in addition to Medicare to help cover what Part A and Part B do not cover.
Medicare Supplements, also known as Medigap insurance, are obtained through private insurance companies. They are, however, all regulated by Medicare. This means that, although the coverage is not through Medicare, Medicare sets guidelines that regulate the coverages to make sure they are all “standardized.” Because they are standardized, there are no network restrictions. Each standardized Medigap policy must offer the same basic benefits, no matter which insurance company sells it. The only difference is the monthly premiums that the policyholder pays. That means that a Plan G coverage with Company X that costs $100/month is the exact same coverage as a Plan G with Company Y, even though the policyholder with Company Y is paying $150/month.
* Note that Plan F and Plan C are being discontinued as of Jan 1, 2020. *
Medicare Advantage Plans:
Also known as Medicare Part C, these plans pay for claims instead of Medicare. Medicare Advantage plans offer a low-cost alternative to Medicare Supplements. They often get criticized, however, because the plans’ coverage can change year-to-year and they also have network restrictions, meaning your doctor/hospital may not accept your insurance. Additionally, because Medicare Advantage Plans are cheaper than Medicare Supplements, the patient will have more copays and deductibles.