There’s no limit on how much you pay out-of-pocket per year unless you have supplemental coverage (i.e., medigap insurance).
Plans have a yearly limit on your out-of-poket costs. If you join a Medicare Advantage Plan, once you reach a certain limit, you’ll pay nothing for covered services for the rest of the year. This option may be more cost effective for you.
Medicare covers medical services and supplies in hospitals, doctors’ offices, and other health care facilities. Services are either covered under Part A or Part B.
Plans must cover all of the services that Original Medicare covers. Some plans offer benefits that Original Medicare doesn’t cover like vision, hearing, or dental.
If you have other types of health or prescription drug coverage, make sure you understand how that coverage works with Medicare. If you have employment-related coverage, or get your health care from an Indian Health or Tribal Health Program, talk to your benefits administrator or insurer before making any changes.
You can add a Medigap policy to help pay your out-of-pocket costs in Original Medicare, like your deductible and coinsurance.
It may be more cost effective for you to join a Medicare Advantage Plan because your cost sharing is lower (or included). And, many Medicare Advantage plans offer vision, hearing, and dental. You can’t use (and can’t be sold) a Medigap policy if you’re in a Medicare Advantage Plan.
You’ll need to join a Medicare Drug Plan (Part D) to get drug coverage.
Most Medicare Advantage Plans include drug coverage. If yours doesn’t, you may be able to join a separate Part D plan.
You can go to any doctor that accepts Medicare.
You may need to use health care providers who participate in the plan’s network. If so, find out how close the network’s doctor or pharmacies are to your home. Some plans offer out-of-network coverage.
The quality of care and services offered by plans and other health care providers can vary.
Original Medicare generally doesn’t cover care outside the U.S. You may be able to buy supplemental insurance that offers emergency care when you travel outside of the U.S.
Plans usually don’t cover care you get outside of the U.S.