Introduction to Medicare

Coverage Choices

You have important decisions to make if you’re eligible for Medicare—but you have choices. Learning as much as possible about each option may help you feel more confident about choosing coverage that fits your needs.

Get to know your coverage choices

When looking at coverage choices, there’s a lot to consider. You may enroll in Medicare Part A (hospital insurance), Medicare Part B (medical insurance) or both. Once you enroll in Original Medicare (Parts A & B), you may have other coverage choices, too, such as a Medicare Advantage plan (Part C), a Medicare Prescription Drug plan (Part D) or a Medicare Supplement insurance plan (Medigap).

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.

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

OR Choose a Medicare Advantage plan.

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

May offer additional benefits not provided by Original Medicare

Medicare coverage choices from the U.S. government

Original Medicare (Parts A & B) is coverage provided by the federal government. It helps pay for hospital stays and doctor visits. But it doesn’t cover everything—and it doesn’t cover prescription drugs. Original Medicare has two parts: Part A and Part B. Let’s learn more.

Medicare Part A: Hospital coverage

What’s covered:

What isn't 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 medications care to manage symptoms and control pain

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:

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 medications care 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

Medicare Part B: Medical coverage

What’s covered:

What isn't 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

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.

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

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There are also coverage choices offered by private insurance companies like UnitedHealthcare Insurance Company (UnitedHealthcare). These include Medicare Advantage (Part C) plans and Medicare Prescription Drug (Part D) plans, and Medicare Supplement plans. Let's learn more.

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There are also coverage choices offered by private insurance companies like UnitedHealthcare. These include Medicare Advantage (Part C) plans and Medicare Prescription Drug (Part D) plans. Let's learn more.

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

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

What’s covered:	What isn't covered:
The same benefits as Original Medicare Parts A and B (except hospice care, which is still covered by Medicare Part A) Most plans cover prescription drugs Some plans may 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	Hospice care, which is still covered by Part A. And benefits can vary by plan

What’s covered:	The same benefits as Original Medicare Parts A and B (except hospice care, which is still covered by Medicare Part A) Most plans cover prescription drugs Some plans may 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 Part A. And benefits can vary by plan

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

If you have special health care or financial needs, you may qualify for a Special Needs Plan. All Special Needs Plans include drug coverage. Other benefits may 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 main types of Special Needs Plans:

Dual-Eligible Special Needs Plans (DSNPs) for people who have both Medicare and Medicaid
Chronic Special Needs Plans (CSNPs) for people living with severe or disabling chronic conditions
Institutional Special Needs Plans (ISNPs) for people who live in a skilled nursing facility
Institutional-Equivalent Special Needs Plans (IESNPs) 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 Prescription Drug (Part D) plans: Get help paying for the prescriptions you take

Medicare Part D is prescription drug coverage. You can get prescription drug coverage with a standalone Part D plan or with a Medicare Advantage plan that includes prescription drug coverage.

What’s covered:	What isn't 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	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)

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
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 plans: Get help paying some out-of-pocket costs

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 $2,240 in 2018 before your policy pays anything.

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

What’s covered:

What isn't 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:

Provider excess charges*
Skilled nursing facility coinsurance or copayment
Foreign travel emergencies**

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

Long-term care
Routine eye exams or eyeglasses
Routine hearing test or hearing aids
Routine dental exams, cleaning or X-rays
Private duty nursing
Days in a skilled nursing facility beyond the 100 days covered by Part A
Prescription drugs

* 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.

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:

Provider excess charges*
Skilled nursing facility coinsurance or copayment
Foreign travel emergencies**

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
Days in a skilled nursing facility beyond the 100 days covered by Part A
Prescription drugs

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

What’s covered:	What isn't covered:
The same benefits as Original Medicare Parts A and B (except hospice care, which is still covered by Medicare Part A) Most plans cover prescription drugs Some plans may 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	Hospice care, which is still covered by Part A. And benefits can vary by plan

What’s covered:	The same benefits as Original Medicare Parts A and B (except hospice care, which is still covered by Medicare Part A) Most plans cover prescription drugs Some plans may 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 Part A. And benefits can vary by plan

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

Dual-Eligible Special Needs Plans (DSNPs) for people who have both Medicare and Medicaid
Chronic Special Needs Plans (CSNPs) for people living with severe or disabling chronic conditions
Institutional Special Needs Plans (ISNPs) for people who live in a skilled nursing facility
Institutional-Equivalent Special Needs Plans (IESNPs) 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 Prescription Drug (Part D) plans: Get help paying for the prescriptions you take

Medicare Part D is prescription drug coverage. You can get prescription drug coverage with a standalone Part D plan or with a Medicare Advantage plan that includes prescription drug coverage.

What’s covered:	What isn't 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	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)

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
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)

Choose the right combination for you

Medicare isn't one-size-fits-all. You can combine different coverage choices, offered through the government or private insurance companies, to get the coverage that is a good fit for you. There are 7 different combinations.

Original Medicare (Parts A and B) or just Part A or just Part B
Original Medicare (Parts A and B) plus a standalone Prescription Drug (Part D) plan
Original Medicare (Parts A and B) plus a standalone Prescription Drug (Part D) plan plus a Medicare Supplement plan
Original Medicare (Parts A and B) plus a Medicare Supplement plan
A Medicare Advantage (Part C) plan with built-in drug coverage
A Medicare Advantage (Part C) plan without drug coverage
A Medicare Advantage (Part C) plan without drug coverage plus a standalone Prescription Drug (Part D) plan

Note: Combination 7 is only available if you choose a Private Fee-For-Service (PFFS) Medicare Advantage plan without drug coverage or a Medicare Savings Account (MSA) plan. These are the only types of Medicare Advantage plans that can be combined with a standalone Medicare Prescription Drug plan.

Medicare Education Home

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The following Exclusions and Limitations apply to AARP Medicare Supplement Plans for residents of Oklahoma:

Benefits provided under Medicare.
Care not meeting Medicare's standards.
Injury or sickness payable by Workers' Compensation or similar laws.
Stays or treatment provided by a government-owned or -operated hospital or facility unless payment of charges is required by law.
Stays, care, or visits for which no charge would be made to you in the absence of insurance.
Stays beginning, or care or supplies received, before your plan's effective date.
Any stay which begins, or medical expenses you incur, during the first 3 months after your effective date will not be considered if due to a pre-existing condition. A pre-existing condition is a condition for which medical advice was given or treatment was recommended by or received from a physician within 3 months prior to your plan's effective date.

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 specific product recommendations for individuals.

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

AARP^® Medicare Supplement Insurance Plans

Insured by UnitedHealthcare Insurance Company, Horsham, PA (UnitedHealthcare Insurance Company of New York, Islandia, NY for New York 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.

This is a solicitation of insurance. A licensed insurance agent/producer may contact you.

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 United Healthcare 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 must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.

The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premium and/or copayments/ coinsurance may change on January 1 of each year.

Get Your Free Medicare Guide

Coverage Choices

Get to know your coverage choices

Medicare coverage choices from the U.S. government

Medicare Part A: Hospital coverage

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

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

Choose the right combination for you

See UnitedHealthcare Plans Available In Your Area

Find a ZIP code

Find a ZIP code

Still Have Questions?

Give Us a Call

Chat with Us Online

Meet with a Licensed Insurance Agent/Producer