Skip to content
My WebMD Sign In, Sign Up

Health Care Reform:

Health Insurance & Affordable Care Act

How to Pay for What Medicare Doesn’t Cover

Medicare Advantage (Part C) Includes Drug Coverage

While Medigap and Prescription Drug Plans are things you addto Original Medicare, Medicare Advantage plans are instead of it.

Medicare Advantage plans are more like private health plans. They're offered by insurance companies. Medicare Advantage plans may cover things that Original Medicare doesn't. For instance, most have built-in drug coverage. Some may have additional benefits -- like dental, hearing, vision, or wellness programs. You usually have to pay an extra monthly fee for a Medicare Advantage plan on top of your monthly Medicare fee.

If you sign up for Medicare Advantage, you can't get a Medigap plan. But if your Medicare Advantage plan doesn't already have drug coverage, you can add on a Prescription Drug Plan.

Each state has many health plans to choose from. If you pick one, you'll use it instead of Original Medicare. 

What it covers: Some Medicare Advantage plans cover prescription medicines and some don’t. You may also get coverage for dental, hearing, vision, and wellness programs. Medicare Advantage plans can change each year. What's covered might change. How much you pay may change, too.

More Ways to Lower Your Costs

Even if you have a Medigap plan and prescription drug coverage -- or a Medicare Advantage plan -- you'll still have medical costs that aren't covered. You may qualify for financial aid to pay all or part of these costs. There are also some other programs and pointers that may help.  

Pharmaceutical Assistance Programs. Some states offer programs that will help you pay for medications. Many drug companies run similar programs themselves.

Cheaper drugs. To lower your expenses, ask your doctor or pharmacist if a cheaper generic drug might work as well as a brand-name medication.

Additional insurance. Depending on your needs, it might make sense to pay for an extra health care policy. You could get a policy for a specific need, like dental care.

Veterans' benefits. If you've served in the military, veterans' benefits may cover some expenses that Medicare doesn't, like prescription drugs

Long-term care planning.
A lot of people think that Medicare covers long-term care -- in a nursing home, for instance -- but it doesn't. Medicaid usually does, but you must have a very low income and low assets to qualify. One possibility is buying long-term care insurance, which will pay at least some of the costs. However, most experts suggest buying it early -- between ages 52 and 64. 

Expert advice. Every state has a State Health Insurance Assistance Program, called SHIP. An advisor there can help you figure out if you need more than just Medicare.

Call Medicare at 800-633-4227 to find the number for the SHIP in your state. Or go to Medicare.gov and pick your state in the pull-down menu called "Find someone to talk to."

WebMD Medical Reference

Calculate
Your Costs

See insurance premium
costs and financial aid.

Start Here

Health Insurance
Advisor

Find a plan that's right
for you.

Start Here

Your State's Insurance Marketplace

Get informed about plans, benefits and costs.

From WebMD
Loading …
URAC: Accredited Health Web Site HONcode Seal AdChoices