Understand the structure

Your Medicare coverage options

There are three main ways to structure Medicare coverage. Each has strengths, costs, and tradeoffs.

A+B

Original Medicare

What it includes: Medicare Part A hospital coverage and Part B medical coverage.
What you pay: Part B premium, deductibles, and generally 20% of covered Part B services.
What may be missing: No built-in annual out-of-pocket maximum for Part A and Part B services, and routine dental, vision, hearing, and prescription coverage are generally separate.
Who it may fit best: People who value broad nationwide access to providers who accept Medicare and do not want plan networks.

Medicare Supplement (Medigap)

What it includes: Original Medicare plus a private Medigap policy that helps pay certain deductibles and coinsurance.
What you pay: Your Part B premium, a Medigap premium, and usually a separate Part D prescription-drug premium.
What may be missing: Routine dental, vision, hearing, and prescription coverage are generally separate.
Who it may fit best: People who want predictable medical costs and broad nationwide access with Original Medicare.

The good: Predictable costs and broad nationwide access with Original Medicare.

The bad: Monthly costs are usually higher, and routine dental, vision, hearing, and prescription coverage are generally separate.

The ugly: You may have three separate monthly premiums—your Part B premium, your Medigap premium, and a separate Part D prescription-drug premium.

Medicare Advantage

What it includes: A private plan that provides Part A and Part B benefits and often includes Part D and extra benefits.
What you pay: Your Part B premium plus plan copays, coinsurance, and any plan premium.
What may be missing: Freedom to use any Medicare provider; networks, prior authorization, referrals, and plan rules may apply.
Who it may fit best: People comfortable with managed-care rules who value one-plan convenience and an annual medical out-of-pocket limit.

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