Medicare is the federal health insurance program for people age 65 and older, and for younger individuals with certain disabilities. It provides essential healthcare coverage — but understanding how it all fits together can be confusing at first.
Let’s break down the basics of Original Medicare, and then explain how Medicare Advantage and Medicare Supplement (Medigap) plans connect to it.
Original Medicare does not cover 100% of your medical costs. You are responsible for deductibles, coinsurance, and copayments — with no out-of-pocket maximum to protect you.
Hospital stays, skilled nursing facility care, hospice, limited home health care
Deductibles, daily coinsurance for extended stays
Doctor visits, outpatient care, preventive services, lab work, durable medical equipment
Monthly premium, deductible, 20% coinsurance
Inpatient hospital care, skilled nursing facility care, hospice care
$1,632 deductible per benefit period; Days 1–60: $0 coinsurance; Days 61–90: $408/day; Lifetime reserve days: $816/day
Doctor visits, outpatient services, preventive care
$174.70 standard monthly premium; $240 annual deductible; 20% coinsurance after deductible
Medicare Advantage (private insurance plans)
Premiums vary by plan and location; copays and network restrictions may apply
Prescription drug coverage
Premiums vary by plan; higher-income individuals may pay more (IRMAA surcharge)
Medicare costs are updated annually by the federal government. Individual costs may vary based on income and location.
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, and any information we provide is limited to those plans we do offer in your area. Please get in touch with Medicare.gov or 1-800-MEDICARE to get information on all your options. Health Insurance sold on mastersonassociates.com is processed through the licensed entity: Masterson & Associates.
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