Your Medicare Coverage Options
Medicare offers several coverage options that can help pay for healthcare services and prescription drugs. This article explains those options and helps you compare them so you can choose the coverage that best fits your needs and budget.
Original Medicare
Original Medicare Parts A and B cover many common healthcare costs, but they don't pay for everything. If you need an item or service Original Medicare doesn't cover, you're responsible for the full cost unless you have additional insurance that provides coverage.
To learn more about Original Medicare, see Medicare Part A Overview and Medicare Part B Overview.
There are two primary ways to get additional Medicare coverage:
Purchase a Medicare Advantage (MA) plan with or without drug coverage.
Keep Original Medicare and add a Medicare Supplement Insurance (Medigap) policy and a Prescription Drug plan (PDP).
Note: You must be enrolled in both Part A and Part B to enroll in an MA, MAPD, or Medigap policy.
If you wish to maintain your current coverage for the coming year, refer to Renewing Your Medicare Plans for Next Year.
Learn more about your coverage options:
Medicare Advantage Plans
A Medicare Advantage (MA) plan provides your Medicare-covered benefits through a private insurance carrier that contracts with Medicare. These plans must provide at least the same coverage as Original Medicare and may include prescription drug coverage.
MA plans must limit your annual out-of-pocket costs for Medicare-covered services. Medicare Part A still covers hospice care. If you enroll in a Medicare Advantage plan, you must continue paying your Medicare Part B premium.
Before enrolling, confirm that your preferred doctors, hospitals, and pharmacies participate in the plan's network.
Review Medicare Advantage Plan Network Types to learn more.
Reasons to Consider Getting a Medicare Advantage Plan
Monthly premiums are often lower than Medigap premiums, although out-of-pocket costs may be higher.
Many plans combine medical and prescription drug coverage in a single plan.
Annual out-of-pocket costs for Medicare services are capped.
You can Shop & Compare plans on our website or call us at 1-866-322-2824 (TTY: 711) to find plans available in your area.
Medicare Supplement Insurance (Medigap) Policies
Medigap policies are offered by private insurance carriers and help pay some out-of-pocket costs not covered by Original Medicare, such as deductibles, copays, and coinsurance.
To enroll in a Medigap policy, you must have Original Medicare. You can’t have both a Medigap policy and a Medicare Advantage (MA) plan.
There are 10 standardized Medigap policies identified by letters. Available plans vary by state, insurance carrier, and coverage options available through Via Benefits.
Compare Medigap Policies
Note: Plans C and F aren't available to people who became eligible for Medicare on or after January 1, 2020. These plans may also be unavailable to some people under age 65. However, you may be able to enroll in these plans if you were first eligible for Medicare before January 1, 2020, even if you hadn’t yet enrolled. Read Medigap Changes to Plan F and Plan C to learn more.
*Plans F & G offer a high-deductible plan in some states. In 2026, you must pay $2,950 in Medicare-covered costs (coinsurance, copays, and deductibles) before the policy begins to pay benefits.
**Plans K & L pay a portion of covered costs until you reach the plan's out-of-pocket limit and satisfy the Part B deductible ($283 in 2026). After that, the policy pays 100% of covered costs.
***Plan N pays 100% of your Part B coinsurance costs. However, you may pay a copay of up to $20 for certain office visits and up to $50 for emergency room visits if you aren’t admitted as an inpatient.
Reasons to Consider Keeping Original Medicare and Adding a Medigap Policy
Visit any doctor or hospital that accepts Medicare.
See specialists without a referral from a primary care provider.
Reduce or eliminate many out-of-pocket medical costs.
While Medigap premiums are generally higher than MA premiums, Medigap policies typically provide more predictable out-of-pocket costs.
You can Shop & Compare plans on our website or call us at 1-866-322-2824 (TTY: 711) to find plans available in your area.
Prescription Drug Plans
Prescription Drug plans (PDPs) are offered by private insurance carriers and help reduce your out-of-pocket prescription drug costs. Plan costs, covered medications, and pharmacy networks vary. When selecting a plan, be sure it covers your medications and includes your preferred pharmacy.
Although prescription drug coverage is optional, you may have to pay a Part D late enrollment penalty if you don't maintain creditable prescription drug coverage. Creditable coverage is expected to pay, on average, at least as much as standard Medicare drug coverage. Contact your current plan if you’re unsure whether your coverage is creditable.
Even if you take few medications or have low out-of-pocket costs, enrolling in a lower-premium drug plan may help you avoid a future late enrollment penalty. All Medicare drug plans must cover a broad selection of commonly used prescriptions.
You can get prescription drug coverage through:
A stand-alone PDP combined with Original Medicare
A Medicare Advantage Prescription Drug (MAPD) plan
Original Medicare provides limited prescription drug coverage and doesn't cover most medications taken at home. Keeping Original Medicare and enrolling in a Medigap policy and a PDP is a good option if you prefer to pay a higher premium and minimize out-of-pocket expenses.
Note: You can't enroll in both a Medicare Advantage plan and a PDP at the same time.
Reasons to Consider a Prescription Drug Plan
Helps reduce out-of-pocket prescription drug costs.
Protects against future Part D late enrollment penalties.
Covers a broad range of commonly prescribed medications.
You can Shop & Compare plans on our website or call us at 1-866-322-2824 (TTY: 711) to find plans available in your area.