There are four parts of Medicare: A, B, C and D, which cover specific services.
Part A provides inpatient/hospital coverage. Part B provides outpatient/medical coverage. Part C offers an alternate way to receive your Medicare benefits (see below for more information). Part D provides prescription drug coverage.
Most beneficiaries choose to receive Part A and Part B benefits through Original Medicare, the traditional fee-for-service program offered directly through the federal government. It is sometimes called Traditional Medicare or Fee-for-Service (FFS) Medicare.
Under Original Medicare, the government pays directly for health care services you receive. You can see any doctor and hospital that takes Medicare (and most do) anywhere in the country. You go directly to the doctor or hospital when in need of care and you don’t need to get prior permission or authorization from Medicare or your primary care doctor.
You are responsible for a monthly premium for Part B. Some people also pay a premium for Part A. Beneficiaries typically pay coinsurance for each service they receive.
There are limits on the amounts that doctors and hospitals can charge for your care.
If you want prescription drug program (PDP) coverage with Original Medicare, in most cases, you will need to join a stand-alone Medicare PDP.
Note: There are a number of government programs that help reduce health care and prescription drug costs, if you meet certain eligibility requirements.
Instead of Original Medicare, you can decide to get your Medicare benefits from a Medicare Advantage Plan, also called Part C. Remember, you still have Medicare if you enroll in a Medicare Advantage Plan. This means that you must still pay your monthly Part B premium (and your Part A premium if you have one).
Each Medicare Advantage (MA) Plan must provide all Part A and Part B services covered by Original Medicare. However, they may have different rules, costs, and restrictions on how and when you receive care.
It is important to understand your Medicare coverage choices and to pick your coverage carefully. How you choose to get your benefits and who you get them from can affect your out-of-pocket costs and where you can get your care.
For instance, with Original Medicare, you are covered to go to nearly all doctors and hospitals in the country. On the other hand, MA plans typically have network restrictions. While this means you will likely be more limited in your choice of doctors and hospitals, some MA Plans do provide additional benefits Original Medicare does not cover, such as routine vision or dental care.
YourMedicare.com takes pride in providing you as much information as possible concerning your Medicare options, but only a health insurance broker licensed to sell Medicare can help you compare your plan options from various insurance companies. When you’re ready, we recommend you discuss your needs with a YourMedicare.com Licensed Sales Agent.