There are two main ways to have coverage under Medicare. There is Original Medicare, which includes your Part A and Part B coverage. Then there is Part C, or Medicare Advantage plans, which give you private insurance through a company. If you are confused by all of these plans, here are each of the plans laid out in easy terms.
Medicare Part A
This is your hospital insurance. Any time a person has to go to a hospital and is required to stay as an inpatient, this is the part of Medicare you will need. Medicare Part A pays for your stay while you are in the hospital. It also covers care in a skilled nursing facility, hospice care, and some home health care as well.
Medicare Part B
Part B of Medicare is your medical insurance. This part is used when a patient visits a doctor or has a need for doctor services, outpatient care, medical supplies, and preventative services. This includes certain blood tests as well.
Medicare Part C
Medicare Part C includes all of the Medicare Advantage plans. These plans are offered by private companies that have contracts with Medicare to provide its users with both Part A and Part B benefits. Medicare Advantage includes health maintenance organizations, preferred provider organizations, private fee-for-service account plans, special needs plans, and Medicare medical savings account plans. If enrolled, most Medicare services are covered through the plan, but aren’t paid for under Medicare Parts A and B. Unlike Part A and B, Medicare Part C will also offer prescription drug coverage.
Part C plans will have much more flexibility since they are provided by private companies. Unfortunately, because of this, you need to read each plan in its entirety and fully understand what is and is not covered. Most of these plans will also cover Medicare Part D, so there is no reason to pay for this service outside of your Medicare Part C. Most of these plans will require you to see doctors within their own specified network. It’s important to be sure that your doctor takes the insurance before purchasing the plan.
Medicare Part D
Medicare Part D adds prescription drug coverage to original Medicare (Part A and B), some Medicare cost plans, some Medicare private-fee-for-service plans, and Medicare medical savings account plans. This plan is offered by insurance companies and other private companies approved by Medicare. The same rules apply for Part D as other Medicare prescription drug plans.
Medigap is also referred to as Medicare Supplemental Coverage. This is insurance you can purchase to cover copayments, coinsurance, and deductibles that you would otherwise have to pay for out-of-pocket. With a Medigap plan, you must first be enrolled with original Medicare (Part A and B). In 2015, there were ten different Medigap plans that you could sign up for and are labeled by letter – A through N in nonconsecutive order. Each plan offers its own benefits so it’s important to fully read and understand each plan.
It is important to note that you cannot be signed up for Medicare Part C at the same time as Medigap. Medigap policies can be purchased from any licensed insurance company in your state and you will be required to pay the private insurance company a monthly premium for coverage. The good thing about Medigap compared to outside private insurance companies is that as long as you pay your premium, the insurance company cannot drop your coverage, regardless of any health conditions you may have.