The Original Medicare Plan

1. Prescription Drugs

Does not pay for prescription drugs

You can’t use a Medigap policy to help pay for prescription drugs.

You can  buy a Medicare Drug  plan that helps pay for prescription drugs.

May pay for some prescription drugs

You can't use a Medigap policy to help pay for prescription drugs.

The plans can change their benefits from year to year.

May pay for some prescription drugs

You can't use a Medigap policy to help pay for prescription drugs.

The plans can change their benefits from year to year.

You may pay more for this benefit.

2. Out-of-Pocket Costs

Premiums

You pay a monthly cost (premium) for Medicare Part B.

You pay a monthly cost (premium) for Medicare Part B.

You may have to pay an additional premium, which will vary by plan.

There are limits on how much the plan can charge for an additional premium.

Some plans may offer you the benefit of paying less than the Part B premium.

You pay a monthly cost (premium) for Medicare Part B.

You may have to pay an additional premium, which will vary by plan.

There are no limits on how much the plan can charge for the additional premium.

Coinsurance/Copayments

You pay a part, called coinsurance, of each service you use. For doctor visits, you usually pay 20% of the Medicare approved amount.

There is a limit on how much doctors and hospitals can charge you.

You pay a set amount, called a copayment, for each service you use. For doctor visits, this could be $10-20.

You do not need and cannot use a Medigap policy.

You pay a part, called coinsurance, of each service you use. The amount you pay depends on the plan.

Plan may let doctors and hospitals charge you more though there may be a limit on how much you pay.

You do not need and cannot use a Medigap policy.

Medicare Supplemental (Medigap) Policy

You can buy a Medigap policy to pay for costs the Original Medicare plan doesn't.

Medigap plans have monthly premiums.

You do not need and cannot use a Medigap policy.

If you already have a Medigap policy, you may want to keep it while you try out a new plan.

You do not need and cannot use a Medigap policy.

If you already have a Medigap policy, you may want to keep it while you try out the new plan.

3. Doctor and Hospital Choice

You can go to any doctor or hospital in the country that accepts Medicare. Most do.

HMO: You can only go to the doctors and hospitals in the plan's network. If the HMO offers a Point of Service option, you can go to doctors outside the network but you will pay more.

You can go to any doctor or hospital that agrees to the plan's payment.

* In all Medicare plans, if you have an emergency or need urgent care, you can go to the nearest doctor or hospital.

PPO: You can go to doctors and hospital outside the plan's network, but you will pay more.

* In all Medicare plans, if you have an emergency or need urgent care, you can go to the nearest doctor or hospital.

* In all Medicare plans, if you have an emergency or need urgent care, you can go to the nearest doctor or hospital.

4. Specialists

You can go directly to a specialist

HMO: You usually need to get a referral from your primary care doctor before going to a specialist.

PPO: You can go directly to a specialist.

You can go directly to a specialist.

5. Travel Coverage

In the U.S. - You are covered anywhere in the country.

In the U.S. - You are only covered in the area served by your plan.

You are covered outside the plan's area if you have an emergency or need urgent care

In the U.S. - You are covered by any doctor or hospital in the country that accepts the plan's payment.

You are covered if you have an emergency or need urgent care.

Outside the U.S. - In most cases, you are not covered.

Medigap plans may cover emergency care outside the country. Check with the plan.

Outside the U.S. - Some plans may cover you. Check with the plan.

Outside the U.S. - Plan may cover you. Check with the plan.

6. Financial Incentives

Doctors and hospitals have an incentive to provide more services.

The health plan has an incentive to restrict services.

The health plan has an incentive to restrict services.