Introduction to Medicare

Coverage Choices

You have important decisions to make when you're eligible for Medicare.

Be confident in choosing coverage that fits your health care and budget needs.

Get to know your coverage choices

When looking at coverage choices, there's a lot to consider. You can enroll in Original Medicare Part A (hospital insurance), Original Medicare Part B (medical insurance), or both. Once you enroll in Medicare, there are more coverage choices you can make. Consider a Medicare Advantage plan (Part C), a Medicare prescription drug plan (Part D), or a Medicare Supplement insurance plan (Medigap) to complete your Medicare coverage.

Original Medicare

Provided by the federal government

Helps pay for hospital stays and inpatient care

Helps pay for doctor visits and outpatient care

Choose to add one or both of the following to Original Medicare

OR choose a Medicare Advantage plan

Medicare Supplement Insurance Plan

Offered by private companies

Helps pay some of the out-of-pocket costs not paid by Original Medicare

Medicare Prescription Drug (Part D) Plan

Offered by private companies

Helps pay for prescription drugs

Medicare Advantage Plan

Offered by private companies

Combines Part A (hospital insurance) and Part B (medical insurance) in one plan

Usually includes prescription drug coverage

Offers additional benefits beyond Original Medicare

Original Medicare coverage from the U.S. government

Original Medicare, provided by the federal government, has two parts: Part A and Part B. Original Medicare Part A helps pay for hospital stays, while Original Medicare Part B helps pay for doctor visits.

Click on the bars below to learn more about what Original Medicare Part A and Original Medicare Part B cover.

What's covered:

Hospital stays and inpatient care, including:

A semi-private room
Hospital meals
Skilled nursing services
Care in special units, like intensive care
Drugs, medical supplies and medical equipment used during an inpatient stay
Lab tests, X-rays and medical equipment used as an inpatient
Operating room and recovery room services
Some blood transfusions in a hospital or skilled nursing facility
Inpatient or outpatient rehabilitation services after a qualified inpatient stay
Part-time, skilled care for the homebound
Hospice care for the terminally ill, including medication to manage symptoms and control pain

What isn't covered:

Personal expenses while hospitalized, like a TV or phone service
Most care outside of the United States
Custodial care (care that helps with daily life activities, like eating and bathing)
Long-term care
Days spent in a psychiatric hospital beyond certain set limits
Hospital stays beyond certain set limits

What's covered:

Doctor visits, including when you are in the hospital
An annual wellness visit and preventive services, like flu shots and mammograms
Clinical laboratory services, like blood and urine tests
X-rays, MRIs, CT scans, EKGs and some other diagnostic tests
Some health programs, like smoking cessation, obesity counseling and cardiac rehab
Physical therapy, occupational therapy and speech-language pathology services
Diabetes screenings, diabetes education and certain diabetes supplies
Mental health care
Durable medical equipment for use at home, like wheelchairs and walkers
Ambulatory surgery center services
Ambulance and emergency room services
Skilled nursing care and health aide services for the homebound on a part-time or intermittent basis

What isn't covered:

Eye exams, eyeglasses or contact lenses
Hearing tests or hearing aids
Dental exams, cleanings, X-rays or routine dental care
Acupuncture
Most prescription drugs

Part B coverage limits: Preventive services and screenings are covered on set schedules, like a yearly flu shot. Other services and supplies must be medically necessary to diagnose or treat a disease or condition.

Coverage choices from private insurance companies

Private insurance companies, like UnitedHealthcare, offer even more coverage options:

Medicare Advantage (Part C) plans
Medicare Prescription Drug (Part D) plans
Medicare Supplement (Medigap) plans

Not all plans are available in all locations.

Click on the bars below to learn more about private insurance coverage options.

Medicare Part C is known as Medicare Advantage. Medicare Advantage plans cover and combine Original Medicare Part A and Part B benefits into one plan. Most Medicare Advantage plans also include prescription drug coverage (Part D) and offer additional benefits not covered by Original Medicare, often with no additional premium.

What's covered:

The same benefits as Original Medicare Parts A and B (except hospice care, which is still covered by Original Medicare Part A)
Most plans cover prescription drugs
Some plans offer additional benefits, like:

Eye exams, eyeglasses and corrective lenses
Dental exams, cleanings and X-rays
Hearing tests and hearing aids
Wellness programs and fitness benefit

What isn't covered:

Hospice care, which is still covered by Original Medicare Part A.
Benefits vary by plan

If you have special health care or financial needs, you may qualify for a Special Needs Plan. All Special Needs Plans include prescription drug coverage. Some plans also include coordination of care, transportation to and from medical appointments, credits to buy everyday health items, and routine vision and dental coverage. There are four types of Special Needs Plans:

Dual-Eligible Special Needs Plans (D-SNPs) for people who have both Medicare and Medicaid
Chronic Special Needs Plans (C-SNPs) for people living with severe or disabling chronic conditions
Institutional Special Needs Plans (I-SNPs) for people who live in a skilled nursing facility
Institutional-Equivalent Special Needs Plans (IE-SNPs) for people who live in a contracted assisted living facility and need the same kind of care as those who live in a skilled nursing facility

Medicare Part D is prescription drug coverage. There are several plan type combinations you can have with a Part D plan:

As a standalone Part D plan
As part of a Medicare Advantage plan that includes prescription drug coverage
In addition to a Medicare Advantage Private Fee-for-Service (PFFS) plan
In addition to a Medicare Supplement insurance plan

What's covered:

Types of drugs most commonly prescribed for people eligible for Medicare (decided by the federal government)
Specific brand name and generic drugs on the plan's drug list (formulary)

What isn't covered:

Drugs not on a plan's drug list
Drugs prescribed for certain cosmetic or non-medically-necessary conditions (decided by the federal government)
Non-prescription drugs
Vitamins and supplements (prescription or over-the-counter)
Drugs received while an inpatient (these might be covered by Part A)

Medicare Supplement insurance, often called "Medigap," helps pay some of the out‑of‑pocket costs not paid by Original Medicare (Parts A and B). There are ten plans standardized by the federal government. Each Medicare Supplement plan offers the same basic benefits no matter which insurance company sells it.

Plan F^† is also offered as a high-deductible plan by some insurance companies in some states. If you choose this option, this means you must pay for Medicare-covered costs (coinsurance, copayments, deductibles) up to the yearly deductible amount of $2,800 in 2024 before your policy pays anything.

Note: In Massachusetts, Minnesota and Wisconsin, there are different standardized plan options available.

What's covered:

All Medicare supplement plans provide these basic benefits:

Medicare Part A coinsurance and hospital costs (an additional 365 days after Medicare benefits are used)
Medicare Part B coinsurance or copayment
Part A Hospice/Respite care
Blood (first 3 pints each year)

Some plans also provide additional benefits, including:

Medicare Part B excess charges*
Skilled nursing facility coinsurance or copayment
Foreign travel emergency**

NOTE: Benefits and costs vary depending on the plan chosen.

What isn't covered:

Long-term care
Routine eye exams or eyeglasses
Routine hearing test or hearing aids
Routine dental exams, cleaning or X-rays
Private duty nursing
Prescription drugs

†Plan F is only available for consumers first eligible for Medicare before 1/1/2020.

* NY: In New York, the Excess Charge is limited to 5%; PA and OH: Note: Under Pennsylvania and Ohio law, a physician may not charge or collect fees from Medicare patients which exceed the Medicare-approved Part B charge. Plans F and G pay benefits for excess charges when services are rendered in a jurisdiction not having a balance billing law; TX: In Texas, the amount cannot exceed 15% over the Medicare- approved amount or any other charge limitation established by the Medicare program or state law. Note that the limiting charge applies only to certain services and does not apply to some supplies and durable medical equipment; VT: Vermont law generally prohibits a physician from charging more than the Medicare-approved amount. However, there are exceptions and this prohibition may not apply if you receive services out of state.

**Care needed immediately because of an injury or an illness of sudden and unexpected onset. Benefit is 80% and beneficiaries are responsible for 20% after the $250 annual deductible with a $50,000 lifetime maximum for medically necessary emergency care received outside the U.S. during the first 60 days of each trip.

Seven plan combination options

Medicare isn't one-size-fits-all. You can combine different plans, offered through the government or private insurance companies, to get the coverage that's a good fit for you. Keep in mind that your health care and budget needs may change over time. When they do, you can be assured there's an option for you.

There are seven different combinations of plans to choose from.

Original Medicare (Part A and/or Part B) alone

Original Medicare (Part A and/or Part B) PLUS a standalone prescription drug (Part D) plan

Original Medicare (Part A and Part B) PLUS a standalone prescription drug (Part D) plan PLUS a Medicare Supplement (Medigap) plan

Original Medicare (Part A and Part B) PLUS a Medicare Supplement (Medigap) plan

Medicare Advantage (Part C) plan with prescription drug coverage (Part D)

Medicare Advantage (Part C) plan without prescription drug coverage (Part D)

Medicare Advantage Private Fee-for-Service plan without drug coverage (Part C) OR a Medicare Savings Account (MSA) PLUS a standalone prescription drug (Part D) plan

Still have questions?

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Meet with a Licensed Insurance Agent/Producer

Make an appointment for Medicare Advantage or Part D Prescription Drug Plans

Make an appointment for Medicare Supplement Insurance Plans

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View Important Disclosures Below

UnitedHealthcare Insurance Company pays royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers. AARP does not employ or endorse agents, brokers or producers.

AARP^® encourages you to consider your needs when selecting products and does not make product recommendations for individuals.

Please note that each insurer has sole financial responsibility for its products.

AARP^® Medicare Supplement Insurance Plans
AARP endorses the AARP Medicare Supplement Insurance Plans, insured by UnitedHealthcare Insurance Company.
Insured by UnitedHealthcare Insurance Company, 185 Asylum Street, Hartford, CT 06103 (available in all states/territories except ND, NY) or UnitedHealthcare Insurance Company of America, 1600 McConnor Parkway, Floor 2, Schaumburg, IL 60173 (available in AR, AZ, IL, IN, MS, NC, ND, NJ, OH, PA, SC, TN, TX) or UnitedHealthcare Insurance Company of New York, 2950 Expressway Drive South, Suite 240, Islandia, NY 11749 (for NY residents). Policy Form No. GRP 79171 GPS-1 (G-36000-4).

In some states, plans may be available to persons under age 65 who are eligible for Medicare by reason of disability or End-Stage Renal Disease.

Not connected with or endorsed by the U.S. Government or the federal Medicare program.

You must be an AARP member to enroll in an AARP Medicare Supplement Plan.

THESE PLANS HAVE ELIGIBILITY REQUIREMENTS, EXCLUSIONS AND LIMITATIONS. FOR COSTS AND COMPLETE DETAILS (INCLUDING OUTLINES OF COVERAGE), CALL A LICENSED INSURANCE AGENT/PRODUCER AT THE TOLL-FREE NUMBER ABOVE.

Medicare Advantage plans and Medicare Prescription Drug plans
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan's contract renewal with Medicare. You do not need to be an AARP member to enroll in a Medicare Advantage plan or Medicare Prescription Drug plan.

This information is not a complete description of benefits. Contact the plan for more information.

WB26621ST (07-19)

Coverage Choices

Get to know your coverage choices

Original Medicare

Medicare Supplement Insurance Plan

Medicare Prescription Drug (Part D) Plan

Medicare Advantage Plan

Original Medicare coverage from the U.S. government

Original Medicare Part A: Hospital coverage

Original Medicare Part B: Medical coverage

Coverage choices from private insurance companies

Medicare Advantage (Part C) plans: Many benefits, one convenient plan

Special Needs Plans (SNPs): Medicare Advantage plans designed for specific needs

Medicare Prescription Drug (Part D) plans: Get help paying for the prescriptions you take

Medicare Supplement insurance plans: Get help paying some out-of-pocket costs

Seven plan combination options

Read Next: Prescriptions, Providers & Benefits

Still have questions?

Give Us a Call

Meet with a Licensed Insurance Agent/Producer

Read Next:

Prescriptions, Providers & Benefits