How Medicare Works
Learning about Medicare can be a daunting task. But it doesn’t have to be. HAP is here, helping you understand the basics of Medicare (Parts A, B, C and D), the three main types of Medicare (Original, Medicare Advantage and Supplemental) and the enrollment timeline (all the way from signing to switching when a plan doesn’t meet your needs).
Types of Medicare
Everyone has different wants and needs. There's no single answer as to which Medicare coverage is best, but HAP can help you find a plan that works for you.
What type of plan should you choose?
| Original Medicare | Medicare Advantage | Medicare Supplement (Medigap) |
|---|---|---|
| Provided by the federal government | Provided by health insurance companies | Provided by health insurance companies |
| Helps pay for hospitals and doctors | Helps pay for hospitals, doctors and other services | Helps pay for hospitals, doctors and other services |
| Includes Parts A and B; No coverage for Part D prescription drugs, dental, hearing or vision | Known as Part C, includes Parts A and B; Most plans offer Part D prescription drug coverage, dental, hearing or vision | Must be enrolled in Parts A and B; No coverage for Part D prescription drugs, dental, hearing or vision |
| Must pay 20% coinsurance for most services (once deductible is met); No limit on out-of-pocket expenses; $0 monthly premium | Many plans require 0-20% coinsurance (once deductible is met); Out-of-pocket maximums protect you; $0 or more monthly premium, depending on the plan | Many plans require 0-20% coinsurance (once deductible is met); Out-of-pocket maximums protect you; Additional monthly premium |
| If you take prescription drugs, see specialists or have to visit a hospital, you may wind up paying hundreds or even thousands of dollars out-of-pocket if you only have Original Medicare | Many people select Medicare Advantage plans because prescription coverage is often included and the monthly premiums are usually much lower | For some people (like frequent travelers), the flexibility and benefits that come with Medicare Supplement (Medigap) plans can justify their typically higher premiums |
| People who sign up for Original Medicare often also purchase a Medicare Supplement (Medigap) plan and a Part D (prescription drug) plan | People who sign up for this usually only have one plan, as most include prescription drug coverage and you won’t need a Medicare Supplement (Medigap) plan | You are only eligible if you have Original Medicare (Parts A and B); People often also sign up for a Part D (prescription drug) plan |
| You will face higher premiums if you don't sign up for Parts A and B on time; Adding Part D later costs more if you don't maintain other equivalent coverage | If you sign up on time for a Medicare Advantage plan that includes Part D, you will not face any penalties; If you're late, the same penalties apply as with Original Medicare | If you enroll after the six-month Medicare Supplement (Medigap) Open Enrollment Period at age 65, you may be charged more for pre-existing conditions or even be turned down |
Health Alliance Plan (HAP) has HMO, HMO C-SNP, HMO-POS, and PPO plans with Medicare contracts. HAP Medicare Complete Duals (HMO D-SNP), HAP Medicare Complete Assist (PPO D-SNP), and HAP CareSourceTM MI Coordinated Health (HMO D-SNP) are Medicare health plans with a Medicare contract and a contract with the Michigan Medicaid Program that provides benefits of both programs to enrollees. Enrollment depends on contract renewals.