Medicare Supplement or Medicare Advantage

Medicare Part A In general, Part A covers: Hospital care Skilled nursing facility care Nursing home care (as long as custodial care isn't the only care you need) Hospice Home health services

Medicare Part A Coverage $1,316 deductible for each benefit period Days 1-60: $0 coinsurance for each benefit period Days 61-90: $329 coinsurance per day of each benefit period Days 91 and beyond: $658 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime) Beyond lifetime reserve days: all costs

Medicare Part B Part B covers 2 types of services Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice. Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best. You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.   Part B covers things like: Clinical research   Ambulance services Durable medical equipment (DME)

Medicare Part B Mental health Inpatient Outpatient Partial hospitalization Getting a second opinion before surgery Limited outpatient prescription drugs

Medicare Part B Premiums File individual tax return File joint tax return File married & separate tax return $85,000 or less $170,000 or less $134 above $85,000 up to $107,000 above $170,000 up to $214,000 Not applicable $187.50 above $107,000 up to $160,000 above $214,000 up to $320,000 $267.90 above $160,000 up to $214,000 above $320,000 up to $428,000 above $85,000 and up to $129,000 $348.30 above $214,000 above $428,000 above $129,000 $428.60

Medicare Part D File individual tax return File joint tax return File married & separate tax return You pay (in 2017) $85,000 or less $170,000 or less your plan premium above $85,000 up to $107,000 above $170,000 up to $214,000 not applicable $13.30 + your plan premium above $107,000 up to $160,000 above $214,000 up to $320,000 $34.20 + your plan premium above $160,000 up to $214,000 above $320,000 up to $428,000 above $85,000 up to $129,000 $55.20 + your plan premium above $214,000 above $428,000 above $129,000 $76.20 + your plan premium

Part B Coverage Deductible of $183 per year. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment. The 20% co-insurance is unlimited

supplemental coverage. Section 1- Learn How Medicare Works j 17 What are my Medicare coverage choices? There are 2 main choices for how you get your Medicare coverage. Use these steps to help you decide. Step 1: Decide how you want to get your coverage. Original Medicare includes Part A (Hospital Insurance) and/or Part B (Medical Insurance) Medicare provides this coverage directly. You have your choice of doctors, hospitals, and other providers that accept Medicare. Generally, you or your supplemental coverage pay deductibles and coinsurance. You usually pay a monthly premium for Part B. See pages 63-66. Medicare Advantage (Part C) includes BOTH Part A (Hospital Insurance) and Part B (Medical Insurance) Private insurance companies approved by Medicare provide this coverage. In most plans, you need to use plan doctors, hospitals, and other providers or you may pay more or all of the costs. You may pay a monthly premium (in addition to your Part B premium), deductible, copayments, or coinsurance for covered services. Costs, extra coverage, and rules vary by plan. See pages 67-80. or Step 2: Decide if you want prescription drug coverage (Part D). If you want drug coverage, you must join a Medicare Prescription Drug Plan. You usually pay a monthly premium. These plans are run by private companies approved by Medicare. See pages 85-96. Step 2: Decide if you want prescription drug coverage (Part D). If you want drug coverage, and it's offered by your Medicare Advantage Plan, in most cases, you must get it through your plan. In some types of plans that don't offer drug coverage, you can join a Medicare Prescription Drug Plan. See pages 85-96. Step 3: Decide if you wan supplemental coverage. t You may want to get coverage that fills gaps in Original Medicare. You can choose to buy a Medicare Supplement Insurance (Medigap) policy from a private company. Costs vary by policy and company. Employers/unions may offer similar coverage. See pages 81-84. Note: If you join a Medicare Advantage Plan, you can't use Medicare Supplement Insurance (Medigap) to pay for out-of-pocket costs you have in the Medicare Advantage Plan. If you already have a Medicare Advantage Plan, you can't be sold a Medigap policy. You can generally only use a Medigap policy if you disenroll from your Medicare Advantage Plan and return to Original Medicare. See page 84. In addition to the options listed above, you may be able to join other types of Medicare health plans. See pages 79-80. Some people may have other coverage like employer or union, Medicaid, TRICARE, or veterans' benefits. See pages 94-96.

Medicare Supplement Insurance is with Medicare. Eligible person can go anywhere in the country that accepts Medicare. Little or no out of pocket for Medicare covered services Multiple plan options. More risk, less premium. Some plans have additional options like gym membership and discounts. Most likely you will be paying a premium for a Medicare Supplement and Drug Plan of at least $120 per month based on the plans that you pick.

Medicare Supplement Supplement plan premiums will increase as you get older. Plans can be priced by gender or Zipcode Plans can be priced by tobacco usage

Medicare Advantage Low or zero premium. Medicare Advantage plans are subsidized by CMS and administered by private insurance companies. Includes PDP Plan A la carte menu of services Different types of plans (Open access HMO, PBP Driven HMO, POS & PPO) Out of pocket Max for Doctor & Hospital