Medicare At A Glance

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•  Covers hospital stays, skilled nursing facilities, hospice, some home health care 
•  Usually no premium if you worked 10+ years (40 quarters) 
•  You pay a deductible before coverage kicks in 

•  Covers doctor visits, specialists, surgeries, outpatient services, lab work, preventive care 
•  Monthly premium applies (taken from Social Security if you’re drawing benefits) 
•  After deductible: Medicare pays 80%, you pay 20% 

•  Offered by private insurers as an alternative to Original Medicare 
•  Combines Part A + Part B, often includes Part D and extras (dental, vision, hearing, fitness, OTC benefits) 
•  Annual out-of-pocket max (financial protection) 
•  Common types:

                   -  HMO – lower cost, must use in-network, referrals required  

                      - PPO – higher flexibility, out-of-network allowed (at higher cost) 

                       - D-SNP – for those who qualify for both Medicare & Medicaid 

•  Helps cover the cost of medications 
•  Available as a stand-alone plan (PDP) or included with Medicare Advantage (MAPD) 
• Freatures : 

-  Formularies (list of covered drugs) 

-  Mail-order savings 

-  Deductible, copays, and coverage stages (deductible → initial coverage → catastrophic coverage)  

•  Extra Help is available for those who qualify based on income 

•  Review your plan every year during Open Enrollment (Oct 15 – Dec 7) 
•  Use preventive services to stay healthy and avoid future costs 
•  Choose generic medications when available 
•  Stay in-network (for Medicare Advantage) to save money 
•  Consider a Medigap (Medicare Supplement) if you want to reduce out-of-pocket costs with Original Medicare 

 
Can I have both Original Medicare and Medicare Advantage? 

Yes.

Do I need more coverage with Original Medicare?
Yes, many people add a Part D drug plan and/or a Medigap plan.

Can I change plans later?
Yes. You can switch during the Annual Enrollment Period (Oct 15 – Dec 7) or during certain Special Enrollment Periods.

Does Medicare cover me abroad?
You're covered for emergency and urgently needed services anywhere in the world.