Medicare Options Comparison

Do you need to switch to Medicare soon?
Are you turning 65 or retiring?

The following chart will give you a quick overview of your options to help you get started on your Medicare journey.

	Original Medicare	Medicare Advantage	Medigap
Type of Coverage	Provided and managed by Federal Government	Provided and managed by private carriers contracted with Medicare	Sold by private carriers approved by Medicare
Providers/Referals	Any provider who accepts Medicare Nationwide, no referral needed	Predetermined Network and you may need a referral to see a specialist	Any provider who accepts Medicare Nationwide, no referral needed
Coverage	Parts A (Hospital) & B (Medical)	Part C (combines A & B into one plan) (replaces your Original Medicare)	Pays 50% to 80%, and in many instances 100% of the costs not covered by Original Medicare*
Deductibles	For Part A – $1,632** For Part B – $240	Varies per carrier, from ZERO to having a separate deductibles for medical care and prescription drugs***	N/A
Copays	Beneficiary pays 20% of approved services (after deductible)	National average $20 per doctor visit, $75 for ER or Urgent Care, copays vary for prescriptions based on drug tiers, generics range from $3-$5	N/A
Out-of-Pocket Maximums	None	Average can range from ZERO to $8,850****	Plans K – $7,060 Plan L – $3,530
Prescription Drugs, Dental, Vision, Hearing	Not part of Original Medicare Parts A & B*****	Some plans include these ancillary benefits	Not covered under Medigap
Average Premiums	Most people Part A is free, Part B rate is $174.70 in 2024******	Each company sets its own rates Average of $25 + Part B standard rate	Rates vary based on age and where you live, national mo. average $70 to as high as $300 in 2024*******
Medical Underwriting	None	You can’t be turned down or charged more because of a health condition during initial open enrollment	Applies only if you miss your initial open enrollment period and do not qualify for a special enrollment********

*Also covers skilled nursing facility and foreign travel. Medigap cannot be purchased if you have Medicare Advantage. The majority of Medigap plans do not cover the Part B deductible of your Original Medicare, and per Medicare, Plans that do cover the Part B deductible (F & C) cannot be offered to new beneficiaries enrolling in Medicare.

** For Medicare Part A there is no coinsurance until you have reached your 60th day of hospitalization in each benefit period. Then you pay $408 per day until the 90th day. If you are in the hospital longer than 90 days, you can pay the full bill yourself or use your lifetime reserve days at $816 per day (up to 60 days in a lifetime).

*** Medicare allows up to $545 maximum deductible in 2024 for Prescription Drug coverage, however, half of all Medicare plans have a much smaller or ZERO deductibles for Part D. Keep in mind, these plans may have higher premiums as a trade-off.

****Unlike Original Medicare that has no maximum out-of-pocket (MOOP), the good thing about Medicare Advantage is you pay nothing for covered healthcare once you hit your annual MOOP. While some MA plans (about 20%) set the MOOP at the maximum allowed by Medicare at $8,850, many other carriers choose to have a much lower or no MOOP.

*****You will need to enroll in a separate Medicare Part D drug plan. To see Part D premiums, copays, deductibles for 2024, please visit our Part D Premiums page.

******To see Medicare premiums, copays, deductibles or 2024, please visit our Medicare premiums page.

*******To see Medigap plans, premiums, copays and deductibles, please visit our Medicare Supplement page.

********You are entitled to the lowest possible rate if you act during the initial open enrollment period. After that, unless you qualify for special enrollment, you will have to go through underwriting and may not get the best rate.

Disclaimers:
While Medicare premiums are the same in many states across the US, rates can and do vary in other states. The content above represents national averages, and some parts were retrieved from Medicare.gov.
DGS Health and Jeanne Clark are not part of the Federal Government Medicare System. The content in this post has not been reviewed or approved by Medicare.

You’ve seen your options. Now see what you should do next.

Making the wrong move with this next phase of your health insurance could wipe out your life’s savings with just one extended hospital stay.

There is never a fee for our guidance and your premiums are the same whether you use a Medicare broker agent or not.

Medicare Basics Learn about the different parts of Medicare

Getting Started Tips for enrolling in Medicare

-Cleanings	-Exams
-X-Rays	-Filling
-Orthodontia	-Glasses, Contacts
-Lasik	-Emergency Care while traveling