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Find a Medicare Policy: Original Medicare and Private Medicare Plans

Christian Worstell by Christian Worstell    |    Published Nov 26, 2019    |    Reviewed by John Krahnert

There are 4 primary parts of Medicare, which include some private Medicare policy options.

Each part of Medicare covers can cover different needs and comes with its own costs, coverage and conditions.

One type of private Medicare policy is Medicare Supplement Insurance (also called Medigap). A Medigap policy can help cover some of the out-of-pocket costs that Medicare doesn’t cover, such as copayments, coinsurance and deductibles.

What Are the 4 Parts of Medicare?

There are 4 different parts of Medicare:

  • Medicare Part A (hospital insurance)

  • Medicare Part B (medical insurance)

  • Medicare Part C (also called Medicare Advantage policies)

  • Medicare Part D prescription drug plans

Medicare Part C plans and Medicare Part D plans are each a different type of private Medicare policy.

Another type of private Medicare policy is Medicare Supplement Insurance (Medigap).

We’ll explain more about each of these types of Medicare coverage below.

What Is Covered by Original Medicare (Medicare Part A and Part B)?

Original Medicare is made up of two parts.

  • Most people qualify for premium-free Part A based on their accumulated time working and paying Medicare taxes. Part A provides coverage for hospital stays and other types of inpatient care. 

  • Medicare Part B is optional and comes with a standard premium of $144.60 per month in 2020.

    Some people who earn higher incomes may pay more for their Part B premiums. This is called the Income-Related Monthly Adjustment Amount, or IRMAA

Part B provides coverage for outpatient care such as doctor’s appointments and some preventive care. Part B also covers some durable medical equipment (DME).

Original Medicare is provided by the federal government, is available to all eligible beneficiaries and is widely accepted all over the U.S. and U.S. territories.

What Are Medicare Advantage (Part C) Benefits?

Medicare Advantage plans are sold by private insurance companies. By law, Part C plans are required to provide all of the same benefits as Medicare Part A and Part B. 

Beyond that basic requirement, some Medicare Advantage plans may then offer some additional benefits not covered by Original Medicare.

Some of these additional benefits may include coverage for things like:

  • Prescription drugs

  • Dental

  • Vision

  • Hearing

  • Certain home care benefits such as home-delivered meals and more

When you have a Medicare Advantage plan, you must still pay the Medicare Part B premium.

Medicare Advantage plans may also charge a monthly premium, but some plans may be available with $0 premiums, depending on where you live.  

The cost and coverage found in Medicare Advantage plans will vary according to carrier and location.

The average premium paid for a Medicare Advantage plan in 2019 was $35.55 per month

What Does a Medicare Part D Policy Cover?

Medicare Part D policies are sold by private insurance companies and provide coverage exclusively for prescription drugs, which is something that is not typically covered by Original Medicare.

A Part D plan adds prescription drug coverage on top of your Part A and Part B benefits. Many Medicare Advantage plans also include Part D prescription drug coverage.

The average premium paid for a Medicare Part D plan in 2018 was $52.23 per month.1 

You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

How Do I Compare Medicare Supplement Insurance Policies?

Medicare Supplement Insurance, or Medigap, provides coverage for some of the out-of-pocket expenses that are tied to Original Medicare. 

For example, beneficiaries of Medicare Part A and Part B still face deductibles, copayments, coinsurance and other costs when they receive care. A Medigap plan can help cover some of these costs. 

There are 10 standardized Medigap plans available in most states, and each one offers a different coverage combination for out-of-pocket expenses. The selection and cost of plans will vary by location.

The average premium paid for a Medigap policy in 2018 was $125.93 per month.2

 

Compare Medigap policies where you live.

Find a plan

Or call --ms-tfn-- to speak with a licensed insurance agent.

 

Choosing a Medicare Policy

With four different types of Medicare policies from which to choose, how do you know which one is right for you?

Let’s take a look at some of the possible combinations of Medicare policies.  

  • Part A only
    You might choose to only enroll in Medicare Part A if you are satisfied with having coverage for only your inpatient care costs. This means you would pay for any outpatient care out of your own pocket or by other means, such as a private, commercial health insurance plan. 

  • Part A and Part B
    You might choose to enroll in Original Medicare alone if you prefer to have coverage for certain inpatient and outpatient care costs.

    In this case, you would pay out of pocket for costs such as Medicare deductibles and copays, as well as for routine dental care and prescription drugs. There is no annual limit on what you can spend out-of-pocket for Medicare-covered services with Part A and Part B.

  • Medicare Advantage (Part C)
    You might enroll in a Medicare Advantage plan if you want the benefits of Medicare Part A and Part B, as well as some additional benefits that a Part C plan may offer.

    Most Medicare Advantage plans offer prescription drug coverage, but some plans may not.

  • Part A, Part B and Part D
    If you wish to have prescription drug coverage in addition to all Original Medicare benefits, you can enroll in Medicare Part A and Part B and then add a Part D plan.

  • Part A, Part B and Medigap
    You might choose to enroll in Original Medicare and a Medigap policy if you want some protection against certain Medicare out-of-pocket costs.

  • Part A, Part B, Part D and Medigap
    If you want coverage for both inpatient care, outpatient care and prescription drugs, and you like having some cost predictability by having some of your Medicare out-of-pocket costs covered, you can enroll in Original Medicare, a Medigap plan and add a Medicare Part D policy.  

Find a Medicare Policy That Works for You

A licensed insurance agent can help you compare Medicare Supplement Insurance policies that are available in your area so that you can find a plan that fits your needs.

 

Find a Medigap policy in your area.

Find a plan

Or call --ms-tfn-- to speak with a licensed insurance agent.

 

1 MedicareSupplement.com’s internal analysis of CMS Medicare Advantage landscape source files, May 2018. Data retrieved from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.

2 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.


 

Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.

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