Medicare Q&A

1. What is Original Medicare?

Q: What is Original Medicare?
A: Original Medicare is a federal health insurance program that includes Part A (Hospital Insurance) and Part B (Medical Insurance). It covers services like hospital stays, doctor visits, and preventive care.

2. What is Medicare Advantage?

Q: What is Medicare Advantage?
A: Medicare Advantage (Part C) is an alternative to Original Medicare. It's offered by private insurance companies approved by Medicare and includes all of Part A and Part B coverage, often with additional benefits like vision, dental, and prescription drug coverage.

3. How are Original Medicare and Medicare Advantage different?

Q: What are the main differences between Original Medicare and Medicare Advantage?
A: Original Medicare is managed by the federal government and allows you to choose any doctor or hospital that accepts Medicare. Medicare Advantage is offered by private insurance companies and often includes extra benefits like prescription drugs, vision, and dental, with additional rules and network restrictions.

4. Does Medicare Advantage include prescription drug coverage?

Q: Does Medicare Advantage cover prescription drugs?
A: Yes, many Medicare Advantage plans include prescription drug coverage (Part D). However, if you choose Original Medicare, you'll need to enroll in a separate Part D plan for prescription drugs.

5. Can I switch between Original Medicare and Medicare Advantage?

Q: Can I switch from Original Medicare to Medicare Advantage?
A: Yes, you can switch from Original Medicare to Medicare Advantage during the Medicare Open Enrollment Period (October 15 – December 7) or if you qualify for a Special Enrollment Period.

6. Is there a cost difference between Original Medicare and Medicare Advantage?

Q: Which is cheaper: Original Medicare or Medicare Advantage?
A: Original Medicare usually has lower monthly premiums but doesn’t cover extra services like dental or vision. Medicare Advantage plans often have lower premiums, but they may have out-of-pocket costs like copayments, deductibles, and network restrictions.

7. Do I need supplemental insurance with Original Medicare?

Q: Do I need supplemental insurance with Original Medicare?
A: Original Medicare covers many healthcare services, but not everything. Many people buy Medigap (Medicare Supplement) insurance to help cover costs like copayments, coinsurance, and deductibles.

8. What additional benefits does Medicare Advantage offer?

Q: What extra benefits are available with Medicare Advantage?
A: Medicare Advantage often provides extra benefits like vision, dental, hearing, wellness programs, and even prescription drug coverage, which aren't included in Original Medicare.

9. Can I see any doctor with Medicare Advantage?

Q: Can I go to any doctor with a Medicare Advantage plan?
A: Medicare Advantage plans may have provider networks, so you may need to use doctors and hospitals that are part of the plan’s network. If you go outside the network, your costs may be higher, or the service might not be covered at all.

10. Do I have to pay a premium for Medicare Advantage?

Q: Do I have to pay a premium for Medicare Advantage?
A: Most Medicare Advantage plans require a monthly premium in addition to your Part B premium. However, some plans offer $0 premiums, but you may still need to pay out-of-pocket costs like copayments or deductibles for services.