Original Medicare is basic medical insurance coverage offered by the U.S. government for people 65 and older, and people younger than 65 with certain conditions. It helps pay for things like doctor visits, surgeries and hospital stays, but it doesn’t cover everything you may need.

You can enroll in Original Medicare through the Social Security Administration (SSA). But to get other important benefits, like prescription drug coverage or hearing and eye exams, you’ll need to consider enrolling in a private Medicare plan that covers more of what Original Medicare doesn’t.

Original Medicare and Medicare Supplement plans don’t include prescription drug coverage (Medicare Part D). If you enroll in one of those plans, you’ll also need to enroll in a stand-alone Part D plan if you want coverage for prescriptions.

If you enroll in a Medicare Advantage plan, Medicare Part D is usually included.

Original Medicare doesn’t have a network. You can see any doctor in the U.S. who accepts Medicare, without a referral.

When you enroll in a private Medicare plan, like a Medicare Cost or Medicare Advantage plan, it’ll have a specific group of doctors, specialists and other providers you can see. This is your Medicare network.

• With our Medicare Cost plans in western Wisconsin, if you see an out-of-network U.S. provider who accepts Medicare and is willing to see you, you’ll pay Original Medicare’s cost sharing amounts.
• With our Medicare Advantage plans in northeast Wisconsin, if you see an out-of-network U.S. provider who accepts Medicare and is willing to see you, you’ll pay the same costs as if your provider were in network.

Original Medicare only covers dental care that’s part of a hospital stay, dental surgery to treat fractures, care needed after jaw surgery, and reconstruction needed after certain procedures and select other situations.

In western Wisconsin, you can add supplemental Medicare dental coverage to most of our Medicare Cost plans if you want.

In northeast Wisconsin, our HealthPartners^® Birch (PPO) Medicare Advantage plan features some dental coverage can be used for certain preventive care and certain comprehensive care.

We also offer separate senior dental plans across Wisconsin.

Original Medicare only covers you in the U.S., where you can see any provider who accepts Medicare and enjoy the same coverage as if you were at home. But if you travel outside the U.S., your Original Medicare benefits won’t travel with you.

All our Medicare plans in Wisconsin include in-network coverage for up to nine months of annual domestic travel. Most plans include worldwide emergency and urgent care coverage too.