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Simply Explained Medicare

How the plan types fit together

Original Medicare, Advantage, prescription cover and supplements — what each one is for, without the alphabet soup.

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Simply Explained

How the plan types fit together

Original Medicare is the government program itself. It covers a great deal and leaves some things out.

A Medicare Advantage plan is the private alternative that delivers your cover through one plan, usually with a network.

Prescription cover — Part D — is about your medications specifically.

A supplement is built to pick up costs that Original Medicare leaves you holding.

Which combination is right depends on your doctors, your medications, and how you would rather handle the costs. That is the whole conversation, and it is worth having with somebody licensed.

Simply Compared

Four plan types, and which ones go together

Four plan types, and which ones go together A four-column comparison of the ACA Marketplace, Medicare Advantage, Medicare Supplement and Medicare Part D. A band across the top separates the Marketplace column, for people not on Medicare, from the other three, for people on Medicare or turning 65. Rows compare who each plan type is for, what it covers, and when you can enroll: the Marketplace from November 1 to January 15 or 60 days after a life event; Medicare Advantage and Part D from October 15 to December 7, with January 1 to March 31 to switch if you are already in an Advantage plan; and a Medicare Supplement in a one-time six-month window that starts when you have Part B at 65. The bottom row shows the two Medicare paths: Medicare Advantage on its own, or Original Medicare with a Supplement and a Part D plan together. You pick one path, not both — a Medigap policy cannot be used with a Medicare Advantage plan. Footnotes: not connected with or endorsed by the United States government or the federal Medicare program; when you first become eligible for Medicare you get your own enrollment window as well; premiums, networks and drug lists differ by plan, county and year, so this compares plan types, not plans. Four plan types, and which ones go together Source: CMS / medicare.gov enrollment rules; healthcare.gov Marketplace dates Not on Medicare On Medicare, or turning 65 ACA Marketplace Obamacare Medicare Advantage Part C Medicare Supplement Medigap Medicare Part D Drug plan Who it's for Self-employed, between jobs, or paying too much On Medicare and comfortable with a network On Medicare, travels or sees specialists Anyone on Original Medicare What it covers A whole private plan: doctors, hospital, drugs Part A and Part B in one plan, drugs usually in it The gaps Original Medicare leaves you to pay Prescriptions only, from that plan's drug list When to enroll Nov 1 – Jan 15, or 60 days after a life event Oct 15 – Dec 7. Jan 1 – Mar 31 if already in one One time only: 6 months from Part B at 65 Oct 15 – Dec 7, every year Which pair up On its own. Not a Medicare plan. One path Advantage alone The other path Original Medicare + Supplement + Part D You pick one path, not both — a Medigap policy cannot be used with a Medicare Advantage plan. Not connected with or endorsed by the United States government or the federal Medicare program. When you first become eligible for Medicare you get your own enrollment window as well. Premiums, networks and drug lists differ by plan, county and year — this compares plan types, not plans. Four plan types, and which ones go together A stacked comparison, one card per plan type, of the ACA Marketplace, Medicare Advantage, Medicare Supplement and Medicare Part D. A band above the first card separates the Marketplace, for people not on Medicare, from the other three cards, for people on Medicare or turning 65. Each card gives who that plan type is for, what it covers, and when you can enroll: the Marketplace from November 1 to January 15 or 60 days after a life event; Medicare Advantage and Part D from October 15 to December 7, with January 1 to March 31 to switch if you are already in an Advantage plan; and a Medicare Supplement in a one-time six-month window that starts when you have Part B at 65. A block below the four cards shows the two Medicare paths: Medicare Advantage on its own, or Original Medicare with a Supplement and a Part D plan together. You pick one path, not both — a Medigap policy cannot be used with a Medicare Advantage plan. Footnotes: not connected with or endorsed by the United States government or the federal Medicare program; when you first become eligible for Medicare you get your own enrollment window as well; premiums, networks and drug lists differ by plan, county and year, so this compares plan types, not plans. Four plan types, and which ones go together Source: CMS / medicare.gov enrollment rules; healthcare.gov Marketplace dates Not on Medicare ACA Marketplace Obamacare Who it's for Self-employed, between jobs, or paying too much What it covers A whole private plan: doctors, hospital, drugs When to enroll Nov 1 – Jan 15, or 60 days after a life event Which pair up On its own. Not a Medicare plan. On Medicare, or turning 65 Medicare Advantage Part C Who it's for On Medicare and comfortable with a network What it covers Part A and Part B in one plan, drugs usually in it When to enroll Oct 15 – Dec 7. Jan 1 – Mar 31 if already in one Which pair up One path: Advantage alone Medicare Supplement Medigap Who it's for On Medicare, travels or sees specialists What it covers The gaps Original Medicare leaves you to pay When to enroll One time only: 6 months from Part B at 65 Which pair up The other path: Original Medicare + Supplement + Part D Medicare Part D Drug plan Who it's for Anyone on Original Medicare What it covers Prescriptions only, from that plan's drug list When to enroll Oct 15 – Dec 7, every year Which pair up The other path: Original Medicare + Supplement + Part D One path Advantage alone The other path Original Medicare + Supplement + Part D You pick one path, not both — a Medigap policy cannot be used with a Medicare Advantage plan. Not connected with or endorsed by the United States government or the federal Medicare program. When you first become eligible for Medicare you get your own enrollment window as well. Premiums, networks and drug lists differ by plan, county and year — this compares plan types, not plans.
Source: CMS / medicare.gov enrollment rules; healthcare.gov Marketplace dates.

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Licensed Insurance Agency. Simply Health Insurance Agency is an independent insurance agency. We are not connected with or endorsed by the United States government or the federal Medicare program.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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