What's happening with Medicare in Washington? Live Q&A with AARP expert 12/5 4:00 p.m. EST

A doctor explains the different ways a patient can get Medicare health and prescription drug coverage.

En español | Do you know that there are different ways you can get your Medicare health and prescription drug coverage? You can choose Original Medicare. This is the traditional fee-for-service plan provided by Medicare. Or, you can choose Medicare Advantage (also known as Part C).

You can also get Medicare prescription drug coverage to help cover some of the costs of your prescription drugs. AARP’s Medicare Question and Answer Tool is a starting point to guide you through the different Medicare plans.

 

 

 

General

Q: What are the different parts of Medicare?

A: There are different parts to Medicare: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage) and Part D (prescription drug coverage). — Read Full Answer

 

 

Original Medicare

 

Q: What is the Original Medicare plan?

A: The Original Medicare plan, also known as traditional Medicare, is a fee-for-service health plan. This means you can choose any doctor or hospital and Medicare will pay its share of the doctor or hospital bill. You pay a portion of the rest. Original Medicare pays for many health care services and supplies, but it doesn’t pay all of your health care costs. — Read Full Answer

 

Q: Does Original Medicare automatically include Part A, Part B and Part D?

A: You get Part A and Part B of the Original Medicare plan when you’re automatically signed up for Medicare. To get drug coverage under Original Medicare, you must choose and join a Medicare-approved Part D private drug plan. — Read Full Answer

 

 

 

Medicare Advantage Plans (Known as Medicare Part C)

 

Q: What are Medicare Advantage plans?

A: Medicare Advantage plans are an alternative to Original Medicare. They also may be known Medicare Part C plans. Medicare Advantage plans are offered by private insurance companies and cover the same health care services as Original Medicare. — Read Full Answer

 

Q: Do Medicare Advantage plans include both Part A and Part B?

A: Medicare Advantage plans must include both Part A and Part B. — Read Full Answer

 

Q: Where do I find information about the different Medicare Advantage plans in my area?

A: To begin your search for a plan, please use the Medicare Plan Finder at www.medicare.gov/find-a-plan, on the official U.S. government site for people with Medicare. — Read Full Answer

 

Q: How are Medicare Advantage plans different from Original Medicare?

A: Medicare Advantage plans are an alternative to Original Medicare. They are known as Medicare Part C plans. These plans are offered by private insurance companies and cover all Medicare-covered services. — Read Full Answer

 

Q: I have a Medicare Advantage plan. Do I still need Medigap insurance?

A: If you have a Medicare Advantage plan, you can’t be sold a Medicare Supplemental or Medigap plan. — Read Full Answer

 

Q: Do Medicare Advantage plans provide the same coverage as Original Medicare?

A: Medicare Advantage plans cover all Medicare-covered services. Most Medicare Advantage plans also include Medicare Part D (prescription drug coverage). They also may pay for additional services that aren’t covered by Original Medicare. — Read Full Answer

 

Q: How do I know if I have the best plan for me?

A: Before you choose a Medicare plan, think about your options carefully. Read through the information that is available on all the plans. Talk to your doctor and friends who have Medicare. Compare the costs, benefits and quality of the plans you are considering. — Read Full Answer

 

Q: Is enrollment in a Medicare Advantage plan automatic or do I need to enroll directly with the plan?

A: Medicare doesn’t automatically enroll you in a Medicare Advantage plan — you need to choose a plan and sign up directly. — Read Full Answer

 

Q: What are my options if my Medicare Advantage plan is ending at the end of this year?

A: If your Medicare Advantage plan is ending at the end of the year, you have two options: You can join another Medicare Advantage plan, or you can enroll in Original Medicare. — Read Full Answer

 

Q: If I am unhappy with my Medicare Advantage plan can I switch plans?

A: Generally, if you join a Medicare Advantage plan, you can only change plans during the open enrollment period that takes place from Oct. 15 to Dec. 7 each year. — Read Full Answer

 

 

 

Prescription Drug Coverage (Medicare Part D)

 

Q: I want to be sure I understand the Part D “doughnut hole” or coverage gap. Could you tell me how it works?

A: There is a coverage gap in Medicare Part D prescription drug plans, also known as a “doughnut hole.” Before the health care law was passed, when your total spending on prescriptions reached a certain limit, you had to pay for all of your prescription drug costs on your own. — Read Full Answer

 

Q: Is it just prescription drug costs that count toward reaching the doughnut hole or all medical costs?

A: Just the amount you and your Part D plan have paid for your outpatient prescription drugs determines when you reach the coverage gap. — Read Full Answer

 

Q: How will I know if I’ve reached the coverage gap?

A: You should receive a monthly statement from your plan showing your total out-of-pocket costs for covered prescription drugs compared with the coverage gap amount. — Read Full Answer

 

Q: How is the doughnut hole going to close?

A: The coverage gap or doughnut hole will gradually narrow until it disappears in 2020. — Read Full Answer

 

Q: When does the doughnut hole go away?

A: The Medicare Part D doughnut hole will gradually narrow until it completely closes in 2020. — Read Full Answer

 

Q: After the doughnut hole is closed, will I still pay 25 percent of my prescription drug costs or only after I reach the catastrophic level of coverage?

A: Once the doughnut hole is closed in 2020, you will pay approximately 25 percent of the cost of your prescriptions until you reach the catastrophic level. — Read Full Answer

 

Q: I think I am going to continue to spend a lot on drugs even after the doughnut hole closes. Will there still be catastrophic coverage even after the doughnut hole closes in 2020?

A: Yes, the catastrophic phase of the Part D benefit is permanent to help protect those people facing the greatest outpatient drug costs. — Read Full Answer

 

 

 

Medigap/Medicare Supplemental Insurance

 

Q: What is Medigap (Medicare Supplemental) insurance?

A: Medigap is also sometimes referred to as a Medicare supplemental insurance. A Medigap policy, sold by private insurance companies, can help pay some of the health care costs (“gaps”) Original Medicare doesn’t cover. — Read Full Answer

 

Q: Is Medigap and Medicare Supplemental Insurance the same thing?

A: Yes. Medigap and Medicare Supplemental Insurance are the same thing. — Read Full Answer

 

Q: Can I have more than one Medigap plan at the same time?

A: By law, Medigap insurers aren’t allowed to sell more than one Medigap plan to the same person. — Read Full Answer

 

Q: How do I find an insurance company that is approved to sell Medicare Supplemental (Medigap) plans?

A: Your state insurance department will have a list of companies approved to sell Medicare Supplemental plans. — Read Full Answer

 

 

 


In the Spotlight

    View More

    In Your City

    Your City Name

    Enter address, city, state, or ZIP code.

    Hide Filter Results
    Filter Results
    Distance (in miles)

      AARP In Your State

      Visit the AARP state page for information about events, news and resources near you.