MEDICARE
Original Medicare + Add-ons
ORIGINAL MEDICARE
ADD-ON
HOSPITAL
PART A
WHAT IT IS
Access to emergency and hospital services.
HELPS COVER
- Inpatient hospital stays
- Care in a skilled nursing Facility
- Hospice care
- Some home health care following a hospital or skilled nursing facility stay
DOCTORS
PART B
WHAT IT IS
HELPS COVER
- Outpatient care
- Many preventative services
- Some home health care
- Durable medical equipment
PRESCRIPTIONS
PART D
WHAT IT IS
HELPS COVER
- Prescription drugs, including recommended shots and vaccines. Covered drugs and payments vary by plan.
HOSPITAL
MEDIGAP
WHAT IT IS
HELPS COVER
- Your out-of-pocket expenses for Original Medicare.
Medicare Advantage
HOSPITAL
MEDIGAP
WHAT IT IS
HELPS COVER
- Everything you get in Original Medicare (Parts A and B and usually D, but not Supplement). May include benefits not covered by Original Medicare, like dental, vision, and hearing coverage.
WHEN YOU NEED TO TAKE ACTION
Enrolling at 65
PART A (HOSPITAL)
PART B (DOCTORS)
PART D (PRESCRIPTION DRUGS)
Retiring after 65
Changing your coverage
Annual Election Period: Between October 15 and December 7 you can join, switch, or drop Prescription Drug or Medicare Advantage plans. Changes become effective on January 1.
Birthday Rule: If you live in CA, OR, ID, IL, or NV and you're enrolled in a Medicare Supplement Insurance plan, you may change to another plan of equal or lesser value each year in the period following your birthday. Special rules apply if you live in IL.
Open Enrollment Period: Between January 1 and March 31, Medicare Advantage enrollees can either switch Medicare Advantage plans or switch to Original Medicare with a Prescription Plan. Each year, you can only change plans once during this period.
This worksheet explains some aspects of how the Medicare program works, but it isn't a legal document. The official Medicare program provisions are found in the relevant laws, regulations, and rulings and on Medicare gov.