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Understanding Medicare and Your Coverage Options

Getting Medicare is a major milestone. As your insurance agent, we want to help you understand what Medicare is and what to consider when choosing the plan that’s right for you.

Medicare is the federal health insurance program for:

  • People who are 65 or older
  • Certain younger people with disabilities
  • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

With Medicare, you have options in how you get your coverage. Once you enroll, you’ll need to decide how you’ll get your Medicare coverage. The 3 main ways are Original Medicare, Medicare Advantage, or Medicare Supplement. When choosing which coverage is right for you, consider:


  • Original Medicare: You pay a monthly Part B premium, and any copayments, coinsurances, and deductibles. There’s no limit to how much you can pay out of pocket, but you can buy a Medicare Supplement Insurance (Medigap) policy to help.
  • Medicare Advantage: You pay the monthly Part B premium plus the plan’s premium (if they have one). You also pay any copayments, coinsurances, and deductibles, but once you reach the plan’s yearly maximum, you’ll pay nothing for health services for the rest of the year.
  • Medicare Supplement: Helps fill “gaps” in original Medicare and is sold by private companies.


  • Original Medicare: Covers services and supplies in hospitals, doctors’ offices, and other health care settings under Part A (Hospital Insurance) or Part B (Medical Insurance). You can add drug coverage by joining a Medicare drug plan.
  • Medicare Advantage Plans: Must cover all services and supplies that Original Medicare covers and most include drug coverage. They may also have extra benefits like dental or vision.
  • Medicare Supplement: A supplement policy can help pay some of the remaining health care costs including copayments, coinsurance, and deductibles.

Doctor and hospital choice

  • Original Medicare: You can go to any hospital and use any doctor that accepts Medicare.
  • Medicare Advantage: You may need to use doctors and hospitals in that plan’s network.

It’s important to understand your coverage options and compare different coverage choices so you can get the coverage that’s right for you.