Medicare Plans Tailored for You-Original Medicare

“We do not offer every plan available in your area. Currently, we represent 9 organizations offering 138 products across all areas. Don’t hesitate to get in touch with medicare.gov, 1-800-MEDICARE, or your State Health Insurance Program (SHIP) to get information on all your options.”

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Original Medicare Plans

What Original Medicare Covers?

Original Medicare includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). Original Medicare covers things like inpatient hospital care, doctors’ services and tests, and preventive services. You pay for services and items as you get them. You must be lawfully present in the U.S. for Medicare to pay for Part A and Part B covered services.

Medicare coverage is based on 3 main factors:

The Medicare coverage is based on 3 main factors:
Federal and state laws.
National coverage decisions Medicare makes.
Local coverage decisions made by Medicare claims processing companies in each state. These companies decide if something is medically necessary and Medicare should cover it in their area.
Explore covered items and services and learn what Original Medicare doesn’t cover (like long-term care, dentures, and routine physical exams).

You Have Medicare Options.

Understanding them matters

If you are new to Medicare or looking to make changes, you have options. Understanding them is key to getting coverage that works best for your health and budget.

Original Medicare has two parts:

Part A

Hospital coverage is included in a Medicare Advantage Plan. Visits – Stays – Home – Hospice are all covered.

Part B

Medical coverage is included in a Medicare Advantage Plan. Preventive – Diagnostic – Treatment Services are all covered.

Fill the gaps of Original Medicare:

Part D

Part D is extra coverage; people with Medicare can choose to help lower the costs of prescription drugs. Medicare-approved private plans offer this coverage.

Part C (Medicare Advantage)

All-in-one plan, also known as Part C. Medicare Advantage is an alternative to Original Medicare for your health and drug needs. You get benefits through a private health plan that Medicare approved. These “bundled” plans include Part A, Part B, and usually Part D.

Medicare Supplement

Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private health insurance company to help pay your share of out-of-pocket costs in Original Medicare, like copayments, coinsurance, and deductibles.

These Are Medicare Plan Handbooks

Medicare & You Handbook 2024

Medicare And You 2026

The “Medicare & You” handbook is your official guide to Medicare. Medicare.gov mails an updated printed handbook to all Medicare households in late September. You can sign up for the electronic version of the handbook on their website and have access to the most up-to-date Medicare information faster.

The handbook is available in many different formats and languages, including large print, braille, and more.

Keep your handbook as a reference. It has important information about:

  • Medicare benefits, costs, rights, and protections.
  • Health and drug plans.
  • Answers to common questions.

Request the official Medicare & You handbook along with a free Medicare plan review with a licensed agent.

The Different Medicare Plan Types Compared

Recommended For
Who do I pay?
Can I go to any doctor?
Where can I get routine (non-emergency) care?
Where can I get emergency care?
Will I need a referral to see a specialist
Is there a limit to my out-of-pocket spending?
Will it pay for extras, like vision and hearing aids?
Medicare A/B
Affordable Basic Option
Part B premiums, deductibles, and coinsurance. Most people would be better off applying for the medicare savings program and selecting a dual snips plan to the right. The dual snip plans may cover some or most premiums you might pay for just Original Medicare / Medicare A & B.Example: For a lengthy Hospital stay you could be responsible for over $50,000 in Medical Bills
Yes, if they accept Medicare but you must satisfy the deductible and 20% coinsurance
Anywhere in the country but you must satisfy deductible
Anywhere in the country but you must satisfy deductible
No
No
Maybe, depending on the plan
Medicare Advantage
Better For People With Low/Average Income
Medicare premiums and plan premium; your plan sets its own copays and deductibles Example: For a lengthy Hospital stay you could be responsible for over $6,000 ANNUALLY plus your monthly premiums
HMO; No, you must go to in-network providers - PPO; Yes
Most plans are restricted to your living area
Anywhere in the country
HMO; Usually - PPO; No
Yes, but YOUR Annual OUT OF POCKET MAX may be as high as $6,000
Maybe, depending on the plan
Dual Snip / Medicare & Medicaid / Medi-Medi
Better For People With Low/Very Low Income
It would depend on the level of the Medicaid or medicare savings program you may qualify for. Example: For a lengthy Hospital stay you may be only responsible for $0.00 - $1000 because the plans may be much richer in benefits than your normal advantage plan.
HMO; No, you must go to in-network providers - PPO; Yes
Most plans are restricted to your living area
Anywhere in the country
HMO; Usually - PPO; No
Yes, depending on the level of the medicare savings program you qualify for it could be ZERO
Maybe, depending on the plan
Medicare Supplement
Better For People With High Income
Medigap premiums, Part B premiums, generally no copayment Example: For a lengthy hospital stay you could have $0.00 to pay out of YOUR OWN POCKET after monthly premiums are met. Medicare Supplement premiums may buy a high out-of-pocket cost dependent upon your living area.
Yes, if they accept Medicare
Anywhere in the country
Anywhere in the country
No, unless you have a Medicare SELECT plan
Yes

What Is The Medicare Savings Program?

Medicare Savings Programs (MSP) are federally funded programs administered by each individual state. These programs are financial assistance programs that help pay some or all of your Medicare premiums, deductibles, copayments, and coinsurance.

What is the LIS Program for Prescription Drugs?

The Low Income Subsidy (LIS) helps people with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage.  We have worked in the community for 20 years helping people qualify for all types of Medicare Savings Programs.

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