Medicare & You: Understanding Your Medicare Choices


Hi, I’m Angela James at the Centers for Medicare & Medicaid Services. Did you know that you can choose how you get your Medicare coverage? Today we’re going to talk about the differences between Original Medicare, Medicare Advantage and prescription drug plans, and Medicare Supplement Insurance Policies – which are also known as Medigap policies. When you’re eligible for Medicare, the first thing to consider is whether you want to get your coverage through Original Medicare or a Medicare Advantage Plan, like an HMO or PPO. Both Original Medicare and Medicare Advantage Plans have both Part A and Part B coverage. Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Part A is free for most people. Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. There’s a monthly premium for Part B. Now, even though both Original Medicare and Medicare Advantage plans cover Part A and Part B services, there are some differences that I want to help you understand. Original Medicare is provided directly through Medicare. You have your choice of doctors, hospitals, and other providers that accept Medicare. Original Medicare covers about 80% of your healthcare costs. Generally you, or any supplemental coverage that you have, pays deductibles and coinsurance and you usually pay a monthly Part B premium. Medicare Advantage Plans, also called Part C, provide coverage through private insurance companies that are approved by Medicare. In most plans, you need to use doctors, hospitals, and other providers that are in your plan’s provider network. If you decide to use a provider outside of your plan’s provider network, you may have to pay more or pay all of the costs. There are usually copayments or coinsurance for covered services, and you may pay a monthly premium in addition to your Part B premium. Each plan has different costs and rules, and some can have extra coverage, like vision or dental. Now I want to tell you about Medicare Prescription Drug Plans, also called Part D. Theseare plans that add drug coverage to Medicare. These plans are run by private insurance companies that are approved by Medicare. To add this coverage, you usually pay a monthly premium. If you have a Medicare Advantage Plan that offers drug coverage, you may have to get that drug coverage through your Medicare Advantage plan. Otherwise, you can join a Medicare Prescription Drug Plan. So do you remember how I told you that Medicare pays about 80% of your healthcare costs? Well, Medicare Supplemental Insurance Policies, or Medigap, is coverage offered through private companies to fill in the gaps in Original Medicare. With a Medigap plan, you pay a monthly premium in addition to your Part B premium and the costs for that premium can vary between policies and companies. You may also be able to get similar coverage through an employer or a union. It is important that you realize Medigap policies don’t work with Medicare Advantage Plans. In fact, if you already have a Medicare Advantage Plan, it’s illegal for someone to sell you a Medigap policy. Now these are just the basics. To get more information about your Medicare choices, visit Medicare.gov. And you can also check out some of our other videos on this YouTube channel to learn more.

64 thoughts on “Medicare & You: Understanding Your Medicare Choices”

  1. I have a hmo,did'nt know i had a choice.some doctors tell you they no longer take hmo's,they pay to slow so what do you do?i'm surfing to web to compare info,i hope that will help me ,turning 65 so confuseing

  2. I just got off the phone with Optima Medicare Advantage who told me I still have to pay part B separately. In this video you say Advantage plans cover part B. Which is it?

  3. When a person presents their insurance card, how am I to know if it's a medigap plan or an advantage plan? To be clear, is the Medigap "in addition to" Medicare A/B and are the advantage plans a replacement to Medicare A/B?

  4. i received , Medicare Summary Notice , for part B (Medical Insurance) and I am trying to understand how to read this. can each section be explained to me? Is there any sites or Apps that could make this eaiser

  5. Its not illegal to sell someone a medigap policy if they have a medicare advantage plan, they just have to tell the customer that they will need to CANCEL said medicare advantage plan.

  6. Its so confusing! And the system is backward! While I worked I paid $11 a month for state health insurance. Now with a disability and nearing retirement my health problems will beggar me! My sister who has great retirement also has VA benefits in addition to her Medicare and can afford the extra expense. I am on a very fixed income and can't afford it. Why do we penalize our seniors for growing old?

  7. HATE VIDEOS with no transcription.  Truly unfair for those with hearing impairment.  Please give me the text.

  8. i agree it is definitely too complicated, if they supposedly automatically enroll you, why then does it become a "maze" when attempting to be fully covered.

  9. What a confusing mess our entire healthcare system is. Especially on medicare since many older adults do not grasp things as readily as they use to or have declining mental health issues. This is scary and confusing and if you pick the wrong one or don't apply during enrollment period they penalize you. what a shame.

  10. You've got to be freakin kidding me!!!  why so many loop holes for the insurance companies and drug companies!  This part that part!  Way too complicated and the reason…. keep us all in the dark and paying HIGH prices!!

  11. I have ben very careful with my diet, I try to eat more vegetables and fruts and I keep checking my blood pressure. Long time ago, my doctor recommended me a prescription for the blood pressure, it was high. I started doing Taichi and in a year my pressure was normal and thepresription was not necessary since then. I am 88 years old and the only prescription I take is a diuretic, I highly recommend the practice of the Taichi

  12. Honestly, I think the whole thing is so confusing intentionally so we elders won't know what we're doing and the Medicare system will get away with not having to pay out. The answer is always $$$$.

  13. I Have Been Permenatly Disabled from prior to my Head on Auto Accident, At 75mph Head on, I already Had Spinal Stenosis before my Auto Accident, on March 27, 2077 and Had Spinal Surgery on my Spine in 2008. I have Never been So Confused as I am now Trying just To Get By every month Alone. All your Medical Plans Are so Confusing and Not Being Able to work due to not only my Chronic Pain there are so many other differant reasons I can't work. I would Much Rather work Than Deal With The threats I get Every Year With SS telling Me they Have to renew my eligability when since My Spinal Cord Operation in 2008, My Neck Back And Entire Body Has Only Become Worse right after my Surgury, Then To fight ebver month and year to be able to afford not only my meds. But be Threatened once a year that I have to be Reviewed. I understand some peoples situations are differant, But When I became Permanatly Disable in 2007, That Means I'm Permenatly Disable And My issues only have gotten worse threw the years, Yes I work my Entire Life, Until My Auto Accident, and Became Perm Disabled. But When All The MRI's I've Had Show how bad my back is crushed and the bones that were removed from neck during my surgury in 2008, My nero surgeons explained to me , one wrong hit to my head , Neck in the right spot and I'll be A Parraplegic from the neck down or possible die. i figured out my pay from SSD and I'm making close to 2-3Dollars per hour. Don't you think if I could work I would.
    I have An Ass. Degree in Engeneering and 25yrs in the Mortgage buisness. Why am I being Harrased Every Year to be Treated like I may be Able to work again. When I'm Perm Disable for Life, And this is not my assesmet, it's from all my Drs. and Nero Surgeons. Telling me I'm very lucky to even be alive. ButUnderstand some People are Facks to just collect $$$. But I'm Not One of These People. Making not even $4.00 Dollars Perhr from SSD, I
    Can't even afford to pay half my bills. No wonder why people like me do't want to live anymore. Trust me I want to Live AND get by, but this currupt world is making it all immposible.
    That Would do anything to be able to To Work Again, But With My Injuries It's Impossible. I'm even having a hard time WRitting this note. But I pray for all us out there that are Truly Perm Disabled Get the HELP WE NEED FROM OUR GOVERMENT. I'm 50yrs old and started working out of High School and have an Ass, Degree. Why When ALL MY DRS. AND NERO SURGEONS ARE TELLING ME I'M LUCKY TO EVEN BE ALIVE AND THAT I HAVE A LIFE LONG PERMANATLY DISABILITY AM I BEING TREATED LIKE I'M GOING TO GET BETTER, WHEN EVER SINCE MY AUTO ACID. AND MY SPINAL SURGURY MY ENTIRE BODY IS IN CHRONIC PAIN AND MORE THAN JUST CHRONIC PAIN, SOMETIMES FROM MY NIGHTMARES WHEN I WAKE UO I CAN'T FEEL HELF OF MY BODY AND I'M ASKED EVERY YEAR ONLY SINCE I MOVED HERE TO FLORIDA, TEXAS TOOK VERY GOOD CERE OF ME, BUT I'M NOT MOVING BACK TO TEXAS CAN;T AFFORD IT.
    I'm So tired of these people who are faking there disability only to get drugs and $$$ from the goverment and then go work under the table for someone and get by fine.
    And Make my Life Miserable tring each year to continue to get my SSD $$$ and fight every day to get my meds because theres these people faking there problems, only to get Meds and $$$$.
    All these fakers are making Us Real Perm Disabled Peoples lifes miserable trying to get our meds evry montH and trying to get by on being paid 2-3$ per hr what my Benifits come oot.
    PEOPLE DON'T UNDERSTAND TO GET PAID ANYTHING FROM ssd YOU HAVE HAD TO WORK YOUR WHOLE OR MOST OF YOUR LIFE TO ENABLE PEOPLE LIKE ME TO EVEN GET PAID FROM ssd, sO DON'T COMPLAINE THAT YOUR PAYING FOR MY TAXES TO NOT EVEN GET BY EBERY MONTH YOU PEOPLE DON'T UNDERSTAND HOW IT ALL WORKS.
    AND HOW MISERABLE OF A LIFE IT IS TO BE PERM. DISABLED FOR LIFE. THANK GOODNESS FOR GOD, AND JESUS. THATS ALL I CAN SAY

  14. Soooo confusing… As we age, we need simplification, not confusion… sorry for seniors (myself included)

  15. I am about to turn 65 and I currently have TriCare Prime. As I understand it I will be getting Parts A & B, and I am OK with that. I also understand that I will have to switch from TriCare Prime to TriCare for Life. My confusion comes where I don't understand if there anything else that I am suppose to sign up for? Additionally where do you get help to get the questions answered?

  16. I think the whole system is designed to increase your blood pressure higher than it already is to cause a heart attack so they don't have to deal with you or pay you any of the money that you have paid to them for most of your life.

  17. The area I am living in has a serious Hep A Problem going on now. I am not finding that Medicare covers the vaccination. I hope I am missing something. Help anyone?

  18. Working in a dermatology practice, I can verify that possible shingles qualifies for an emergency visit. Shingles frequently causes extreme pain for weeks and can damage an area such as an eye, including sight. Shingles is best treated with 24 hours with an anti-viral medication. Its unfortunate, some people are reporting injection reactions, but if see or meet someone with the active disease, you might be thinking more seriously of taking the vaccine.

  19. Once you hit Medicare, the goal is to make it so confusing, you do not even understand they are stealing your monies every month…. We do not have a health care problem in this country it is truly an INSURANCE NIGHTMARE!! Just to keep up with the changes requires you to constantly read your plan and update every year. As we age most people do not have health advocates to guide them thru this most difficult process.

  20. I've worked with computer programs most of my adult life and have NEVER run across something as difficult as this – even the website makes it difficult to get the information you need.  Those with any mental decline will NEVER get or find what they actually need this way.  Tried to get information for my mother (in her 90's) and almost forgot what we wanted when holding on to the phone for 55 minutes waiting for the call to be handled.  She waste a whole day at the office waiting for her number to be called,  only to find that she had to do something else or didn't bring the correct information with her.  What happened to all those things that were supposed to simplify the procedure?

  21. The misconceptions surrounding Medicare comes from where Medicare Beneficiaries get educated on the 2 Medicare options. And, who they Trust with their Medicare Insurance. Agents/brokers/Companies are competing for your business to a fault because marketing a brand or plan adds to the confusion and can down right feel overwhelming to most Medicare Beneficiaries.
    The best way millions of Medicare Beneficiaries have found peace of mind is having a licensed and trusted Medicare advisor not only educate with the "Medicare and You handbook" that is written by the government but also have the advisor become your advocate each and every year. Meaning, they will help to update you on the changes that happen with Medicare and also review your #MedicareSavings and Options each and every year after. Its all about trust. There are many very good Medicare Insurance brokerages and firms out there who are able to shop the market for you. I hope this helps. 1-800-Medicare Tip Video: https://youtu.be/4D1W8o8KdeI

  22. I am a 71 year old Vietnam Veterans. During this current year the Veterans' Administration has me listed at 100% Disabled/Service-Connected. 
    I started getting Medicare Part A on 03/01/2012 and Medicare Part B on 06/01/2015. My VA Doctor appointments and VA Prescriptions are free for me, so my question is: Do I still need to maintain Medicare Part B or can I drop it because I have free lifetime medical care and prescriptions for the rest of my life? Thanks for your prompt response.

  23. https://www.medicare.gov/sites/default/files/2018-09/10050-medicare-and-you.pdf There 120 pages of information will help you understand more.

  24. All I wanted to do was find a
    Medicare/Medicaid doctor near me. It seams that that is one of the hardest things to do. Lord help me please

  25. I’ve been on disability for 19 years from Rsd I had magnacare through my spouse as primary but now I’m divorced how do I get drug coverage and a secondary. I’m a single mom disabled I livre in New York on Long Island

  26. It's genes, genes, genes. I eat right, weight is good, take the statin and the only way I could get my cholesterol under control was to stop eating meat. BTW, these tests should be done every year. The problem is getting the person to go to the doctor.

  27. I agree, what a mess! I couldn't follow her for more than 30 seconds. This speaker has no concept of how difficult it is for older adults to grasp what heck she's saying. Yes, a confusing mess! I should know, turning 71 this year, I am confused and angry because I cannot follow what the heck she's saying. HELP!!!

  28. Your right it shouldn't be that hard I have coverage through employer and I don't want medicare right now Can't they just tell me what I HAVE to sign for right now

  29. i dont understand what i should do do you us your husband your on first as the primary and medicare as secondary or the other way around i've been told to many different ways

  30. True it is complicated, but you should find a trustworthy advisor to help you sort through the clutter! There is a cost to having truly comprehensive Medicare coverage, but it's worth it in the long run. An advisor who has YOUR best interest in mind, will ask you some important health and financial questions to narrow down your choices and add clarity to this issue.

  31. From the CMS Sept. 2019 ~ Medicare Advantage fraud cost $30 billion over the last three years alone. (2016 – 2019).
    In an audit of 37 Medicare Advantage plans, auditors were only able to confirm 60 percent of more than 200,000 health conditions. This means nearly that half (or 40%) of all reported medical conditions were falsified by insurance companies.
    American greed knows no boundaries. Insurance companies are raping Medicare and the US citizens…. and no one is stopping them.

  32. It's actually very simple and easy to understand, but it seems the people at Medicare just want it to be more confusing. If you have Medicare A and B and your former employer's health plan, you have all of the coverage you need. A Medicare Advantage plan (Part C) is usually offered by a health company (such as Blue Cross/Blue Shield) and rarely covers you as well as when you carry your former insurance company. Although they may tell you they cover dental and vision benefits, they usually only cover one cleaning per year and half price for frames and lenses. You're better off without it in just about all cases. Part D, the prescription coverage, will be picked up by your former employer's plan in addition to what Medicare doesn't pay. All of my doctors accept Medicare as full payment for their services. Check with your physicians. Another negative thing about a Medicare Advantage Plan is that you usually have no choice of providers and it works similar to an HMO. Not a good choice, IMO. It's often a rip-off from some companies in terms of not getting what you thought you had paid for.

  33. It is great to have options, work with a licensed insurance agent who represents multiple carriers (a broker). The Broker like myself should not charge a fee as we get paid by the insurance carrier. If you are in WI look us up to assist!

  34. I am already on SS and just turning 65 in October. They say you are automatically signed up if on SS. I have Not received my card nor any booklets on Medicare and my options. Call the SS office and said it was sent out 2 months ago but I haven't received it I told her. She told she send me another card and it would be 14 days. It has been 21 days and nothing. Called and checked if they had correct address which it was. Seems like a bunch run around.

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