When it comes to choosing a Medicare plan, it helps to understand the different types of plans, how they work and the coverage they provide. Whether you’re brand new to Medicare plans, looking to switch plans or just need a refresher, we’re here to help guide you along the way and answer your questions.
Original Medicare covers the basics, but not much more. There are many important services that Original Medicare doesn’t include, like prescription drug coverage, hearing exams and eye care.
When you need more coverage than you get with Original Medicare, consider enrolling in a plan with additional coverage from a private insurer like HealthPartners.
Here are some things to keep in mind about private Medicare plans:
- Each plan has its own premium, deductible, copay and out-of-pocket maximum amounts.
- Your choice of plans will depend on where you live – different plans are offered in different counties.
- Once you enroll in a private Medicare plan, you don’t need to renew it each year, but you may have opportunities to switch plans if your needs change.
You can compare different types of private Medicare plans to better understand how they work and the coverage they provide.
Medicare Advantage plans combine the coverage of Original Medicare Parts A and B into one plan (often called Part C), giving you the convenience of one plan for all your coverage.
They usually offer additional benefits and perks on top of Original Medicare, such as dental and Part D prescription drug coverage.
Medicare Cost plans also offer additional benefits and perks on top of Original Medicare.
While Medicare Advantage plans take the place of Original Medicare, Cost plans work alongside Original Medicare. This means you can drop your Cost plan and go back to Original Medicare at any time. And if you go out of network for care, your Original Medicare benefits will kick in for covered services.
Medicare Supplement plans help bridge the gaps between what Original Medicare covers and your total expenses for deductibles, copays and coinsurance.
When you receive care, Original Medicare will pay its share for covered services, then your Medicare Supplement plan will pay its share. You’ll be responsible for any remaining cost not covered by your Supplement plan. Medicare Supplement plans don't include Part D coverage.
Medicare Part D helps cover the cost of your prescriptions. You can enroll in a stand-alone Part D plan to add drug coverage to Original Medicare, a Medicare Cost plan or a few other types of plans.
Remember: If you want the convenience of one plan for all your coverage, most Medicare Advantage plans include Part D coverage.
If you’re not sure which kind of Medicare plan will meet your needs, answering a few questions may help you compare plan details.
If yes: The more times you visit your doctor(s), the more coverage you may need. If you see your care team multiple times a year, it‘s worth looking for plans with lower deductibles and lower out-of-pocket maximums.
If you have a strong relationship with your current care team, you’ll want to make sure you choose a plan that includes them in its network. Also, make sure needed specialty care is covered by your plan and confirm whether you need a referral to see a specialist.
If no: You can be more flexible in the plans you choose.
If yes: Consider a Medicare plan that includes prescription drug coverage. When you find a plan you like, look through the plan’s drug list (formulary) to see if your medications are listed as preferred medicines.
If no: Even if you don’t use prescription drugs right now, you may still want to consider Medicare Part D to avoid a late-enrollment penalty later.
If yes: A plan with low out-of-pocket maximums might be better for you.
People who exceed their out-of-pocket maximums or deductibles tend to get care regularly. Though your monthly premiums may be higher in a plan with low out-of-pocket maximums, your copays and coinsurance amounts may be lower when you visit the doctor.
If no: If you stay well under your deductible or out-of-pocket maximum each year, a plan with higher out-of-pocket maximums could be a good fit.
People in this situation usually don’t get care very often. Your copays and coinsurance amounts may be higher when you visit the doctor, but your monthly premiums will typically be lower.
If yes: You might be okay having separate plans for medical and prescription drug coverage. These plans usually come with separate member ID cards, additional paperwork and different service teams.
If no: You could find having all your Medicare benefits in one plan to be more convenient and less stressful.
With more than 60 years of experience and service, we’re here to help you find a Medicare plan that works for you.
Combined medical and prescription drug coverage with extra perks and benefits
Available in select counties in Minnesota and Wisconsin
Medical-only coverage with extra perks and benefits
Available in select counties in Minnesota, Wisconsin, North Dakota and South Dakota
Medical-only coverage that fills the gaps in Original Medicare
Available statewide in Minnesota
Looking for plans in Iowa or Illinois? Our friends at HealthPartners UnityPoint Health are ready to help.
Last updated October 2021
H2422_001601 Approved 10/1/2021
H2462 H4882_001601 Accepted