Guide to Understanding Medicare

Medicare Coverage Choices

Guide to Understanding Medicare / Medicare Coverage Choices

You have 4 basic coverage choices if you’re eligible for Medicare:

1. You can rely on Original Medicare (Parts A and B) to provide your coverage. Original Medicare is provided by the federal government and offers Medicare Part A (hospital) coverage and Part B (medical) coverage. Usually, a fee is charged for each healthcare service or supply you get. This fee is in addition to the Medicare Part B premium, which you must pay each month. In 2025 the standard Part B premium is $185.00.

What many people don’t know is that Original Medicare doesn’t cover everything. Original Medicare only pays about 80 percent of your Part B medical expenses. There’s a deductible for each benefit period when you are hospitalized. Plus there is an annual deductible for Part B before any benefits are paid; in 2025 that annual deductible is $257.


2. You can choose a Medicare Advantage plan (Part C) instead of Original Medicare.
Most Medicare Advantage plans provide extra benefits like dental, hearing aids, prescription drug coverage, reimbursements for eyewear, fitness, transportation, and even Special Needs Plans for chronic conditions.

Most Medicare Advantage plans also cover worldwide emergency and urgent care (an important benefit Original Medicare does not cover), and Medicare Advantage plans cap your out-of-pocket medical expenses so you have peace of mind in knowing your total covered medical costs are limited to an annual amount.

Medicare Advantage plans are all-in-one coverage. You get medical and, with most plans, prescription drug coverage. With Original Medicare you need a stand-alone Prescription Drug plan, and if you want to cover the gaps in Original Medicare, a Medicare Supplemental plan.


3. You can choose a Medicare Supplement plan to fill coverage gaps in Original Medicare, like the annual hospital deductible ($1,676 in 2025), the Part B Premium ($185.00 in 2025), and the coinsurance of 20 percent of Part B medical costs. Some Medicare Supplement plans offer worldwide coverage for emergencies and fitness benefits.

You could be subject to pre-existing limitations to exclude certain medical conditions you had prior to becoming a Medicare Supplement member. And you must purchase a separate prescription drug plan if you want your out-of-hospital drugs covered.


4. You can add a prescription drug plan (Part D) to Original Medicare by joining a Medicare prescription drug plan. Stand-alone prescription drug plans can be combined with Original Medicare and/or a Medicare Supplement plan. If you’re eligible to join a Medicare prescription drug plan and choose not to enroll, you may have to pay a late enrollment penalty when you do join.

Need More Assistance?

Download the Simple Guide to Medicare Booklet