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The Medicare Program
includes the following coverage options:
Original
Medicare Plan
The Original Medicare Plan is a fee-for-service plan that is available
nationwide. With the Original Medicare Plan, you may go to any doctor,
specialist, hospital, or other health care provider that accepts Medicare.
Generally, you are charged a fee each time you receive a service from
that provider. You pay a set amount (deductible) each year. Once your
deductible is satisfied, Medicare pays its share, and you pay your share
(coinsurance or copayment). You may want supplemental insurance to help
pay the costs Medicare does not cover. We will discuss
Medigap, also called Medicare Supplement Insurance, in a later lesson.
Medicare
Advantage and Other Medicare Health Plans
Medicare Advantage and other Medicare Health Plans provide care under
contract to Medicare and currently include managed care plans such as
Health Maintenance Organization (HMO) Plans, Preferred Provider Organization
(PPO) Plans, Special Needs Plans, and Medicare Private Fee-for-Service
Plans. These plans are not available in all areas of the country. By
joining a Medicare Advantage Plan, you can often receive extra benefits
(i.e., prescription drugs). Medicare Advantage Plans may have additional
rules, and you may have to pay a monthly premium for the extra benefits.
Other Medicare Health Plans include Medicare Cost Plans, Demonstrations,
and PACE (Programs of All-inclusive Care for the Elderly).
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