The Original Medicare Plan – This is a fee-for-service plan that covers many health care services and certain drugs. You can go to any doctor or hospital that accepts Medicare. When you get your health care, you use your red, white, and blue Medicare card.

The Original Medicare Plan pays for many health care services and supplies, but it doesn’t pay all of your health care costs. There are costs that you must pay, like coinsurance, copayments, and deductibles. These costs are called “gaps” in Medicare coverage. You might want to consider buying a Medigap policy to cover these gaps in Medicare coverage. You can also add prescription drug coverage by joining a Medicare Prescription Drug Plan.

For more information on the Original Medicare Plan, visit the Original Medicare Plan section of this website.

Medicare Advantage Plans – Available in many areas. If you have one of these plans, you don’t need a Medigap policy. These plans include:

Health Maintenance Organizations (HMO),
Preferred Provider Organizations (PPO)
Private Fee-for-Service Plans
Medicare Special Needs Plans
Medicare Medical Savings Account Plans (MSA)
These plans may cover more services and have lower out-of-pocket costs than the Original Medicare Plan. Some plans cover prescription drugs. In some plans, like HMOs, you may only be able to see certain doctors or go to certain hospitals to get covered services.

Click here for more information on Medicare Advantage Plans.

Medicare Prescription Drug Plans – These stand-alone plans add prescription drug coverage to the Original Medicare Plan, some Medicare Cost Plans, some Medicare Private Fee-for-Service Plans and Medicare Medical Savings Account Plans. Click here for more information on Medicare Prescription Drug Plans.

The Medicare plan that you choose affects many things like cost, benefits, doctor choice, convenience, and quality. To compare your Medicare Health Plan choices, go to the Medicare Options Compare. To compare Medicare Prescription Drug Plans, go to the Medicare Prescription Drug Plan Finder.

States also have programs that pay some or all of Medicare’s premiums and may also pay Medicare deductibles and coinsurance for certain people who have Medicare and a low income. To qualify, you must have:

Part A (Hospital Insurance),
Assets, such as bank accounts, stocks, and bonds that are not more that $4,000 for a single person, or $6,000 for a couple, and
A monthly income that is below certain limits.
For more information on Medicare savings programs, look at the Medicare Savings Programs publication.

Deductible

$1,100.00 (Per Benefit Period)
Coinsurance

$275.00 a day for the 61st – 90th day each benefit period.

$550.00 a day for the 91st – 150th day for each lifetime reserve day (total of 60 lifetime reserve days – non-renewable).

All costs for each day beyond 150 days.

Skilled Nursing Facility Coinsurance

Up to $137.50 a day for the 21st – 100th day each benefit period.
Part B: (Medical Insurance)

Deductible

$155.00 per year. (Note: You pay 20% of the Medicare approved amount for services after you meet the $155.00 deductible.)
Important Note: Most benficiaries will continue to pay the same $96.40 premium amount they pay today. For additional details, see our FAQ titled: Will my Medicare Part B premium increase in 2010?