What are the main types of Medicare coverage?

In understanding the basics of Medicare, it’s important to learn the different types of Medicare coverage and what they generally offer:

• Original Medicare is a fee-for-service health plan that has 2 parts: Part A (Hospital Insurance) and Part B (Medical Insurance). You can go to any doctor, supplier, hospital, or other facility that accepts Medicare, and is accepting new Medicare patients.
• Medicare Advantage, also known as Part C, is a type of Medicare plan offered by a private company, like Cigna Healthcare^®. These plans provide you with all your Medicare Part A and Part B benefits and may include plan extras not offered by Original Medicare.
• Medicare Part D Prescription Drug Coverage provides optional prescription drug coverage to anyone with Medicare. Private companies, like Cigna Healthcare, offer this as a standalone Part D plan or with select Medicare Advantage Plans.
• Medicare Supplement (also known as Medigap) insurance includes plans offered by private companies like Cigna Healthcare.¹ Plans help cover costs that Original Medicare doesn’t, including deductibles, copays, and coinsurance.

What are the basics of Medicare?

Here’s a quick overview of what each part of Medicare covers and how they work together:

Part A and Part B (Original Medicare) is the federal government’s Medicare program:

• Part A covers you for hospital care and services. This includes inpatient hospital stays, surgeries, and more.
• Part B covers two types of services: medically necessary services (services or supplies needed to diagnose or treat a medical condition), and preventive services (health care to prevent illness or detect it in an early state, including doctors’ visits, preventive care, ambulance, and durable medical equipment).
• Original Medicare works with:
  • Medicare Supplement Plans
  • Standalone Part D Prescription drug plans
  • Or, use it alone with no additional coverage

Learn more about Part A and B (Original Medicare)

Medicare Advantage Part C is part of the government’s Medicare program, but is offered and managed through private insurers like Cigna Healthcare.

• Includes Part A hospital and Part B medical coverage.
• Part D prescription drug coverage is usually included.
• Other coverage may include some basic dental, vision, and hearing depending on the plan and insurer you choose.
• Part C works with:
  • Standalone Part D Prescription drug plans (if they are not already included as part of the Part C plan or cannot be included due to certain types of plan designs).

Learn more about Part C

Medicare Part D Prescription Drug Coverage is part of the government’s Medicare program, but is offered and managed through private insurers like Cigna Healthcare.

• Part D plans cover costs for various types of prescription drugs, depending on the plan you choose.
• Part D works with:
  • Original Medicare (Part A and B)
  • Medicare Supplement policies
  • Many Medicare Advantage plans come with some prescription coverage already included

Learn more about Part D

What are the basics of Medicare Supplement Insurance (Medigap)?

Medicare Supplement Insurance is not part of the federal government’s Medicare program. These policies are sold through private insurers like Cigna Healthcare and designed to help cover some expenses not covered by Original Medicare:

• Helps pay Part A and sometimes Part B annual deductibles.²
• Helps pay copays, coinsurance and other out-of-pocket costs you may owe for services.
• Medicare Supplement works with:
  • Original Medicare, alone
  • Original Medicare plus Part D Prescription Drug plan

Learn more about Medicare Supplement

How does Medicare work?

Signing up for Medicare: When you turn 65 you must choose either to sign up for Original Medicare (Parts A and B) or a Medicare Advantage Plan through a private insurer.³

• You are eligible to sign up during the 3 months before the month in which you turn 65, during your birthday month, and through the 3 months that follow your birthday month. So you have 7 months in which to sign up for Medicare.
• Note: If your birthday falls on the 1st of the month, your initial enrollment period starts 4 months before your 65th birthday and ends 2 months after your 65th birthday. Generally, your Medicare coverage starts on the 1st day of the month before you turn 65.

If you have End Stage Renal Disease or a chronic condition or disability for which you receive Social Security benefits, you would be eligible for Medicare, regardless of age.

Medicare annual open enrollment: Medicare Open Enrollment usually runs from October 15 to December 7, each year. During that time you can decide if you want to make any changes to your current Medicare coverage. For example, if you signed up for Original Medicare when you turned 65, you may decide you want to try a Medicare Advantage plan instead, or vice versa.

Signing up* for a Medicare Supplement Insurance policy (Medigap): If you are 65 or older and have signed up for Original Medicare then you may be eligible for a Medicare Supplement insurance plan. These plans are not part of the federal government’s Medicare program and are sold exclusively through private insurers.

Open Enrollment is a 6-month period when you can buy any Medicare Supplement policy sold in your state, even if you have pre-existing health conditions. This period automatically starts on the first day of the month that you meet both of the following 2 criteria:

• You’re 65 (or older) and
• You’re enrolled in Medicare Part B (Medical Insurance)

*You can apply for a Medicare Supplement policy any time during the year, however during your Open Enrollment period, you are guaranteed Medicare Supplement coverage. When applying outside of your Open Enrollment period, you may be subject to restrictions based on your previous health history or current medical conditions, and you could also be denied acceptance.

How much does Medicare cost?

Medicare is not free. The different types of Medicare each have certain out-of-pocket costs:

• Original Medicare Part A and Part B come with monthly premiums that vary from year to year, depending on your income level. Part A and Part B each has its own annual deductible, as well as copays and coinsurance for care and services. Learn more about Original Medicare
• Part C, or Medicare Advantage plans, often come with low or no monthly premiums, depending on the plan. You will pay copays for specialist doctor visits, some of the cost for other various services and care, as well as copays for prescriptions if included in the plan. Costs and coverage can vary.
• Part D prescription plans have a monthly premium, as well, and may also have a prescription deductible depending on the types of prescription drugs you need.
• Medicare Supplement plans have monthly premiums, which help pay some of the health care costs that Original Medicare doesn’t cover.