Medicare plan types, explained in plain English

Start here: what Original Medicare covers — and what it doesn't

Original Medicare is the federal program you pay into while working. It has two parts:

• Part A (hospital insurance) — inpatient hospital stays, skilled nursing care after a hospital stay, and hospice. Most people pay no premium for Part A.
• Part B (medical insurance) — doctor visits, outpatient care, lab work, and preventive services. Part B has a monthly premium.

Original Medicare covers a lot, but it leaves real gaps: after your deductibles, you generally pay about 20% of Part B costs — with no yearly limit on what you could owe — and it doesn't cover most prescription drugs. That's why nearly everyone adds coverage in one of the two ways below.

Path 1: Medicare Advantage (Part C)

Medicare Advantage plans are offered by private insurance companies as an alternative way to receive your Medicare benefits. You're still in the Medicare program — you just get your coverage through the plan instead of through Original Medicare directly.

What people tend to like:

• One plan, one card — hospital, medical, and usually drug coverage bundled together.
• Many plans in Florida have low monthly premiums, and every plan includes a yearly cap on your out-of-pocket medical costs.
• Extras Original Medicare doesn't offer, like dental, vision, hearing, or fitness benefits, are common.

What to weigh carefully:

• Most plans have provider networks (HMO or PPO). Your doctors and hospitals matter — we check them before anything else.
• Some services need plan approval (prior authorization) before they're covered.
• Costs come as copays as you use care, rather than one predictable premium.
• Plan details can change each year, which is why an annual review matters.

Path 2: Medicare Supplement (Medigap)

A Medigap policy takes the opposite approach: you stay on Original Medicare, and the policy helps pay your share — deductibles, coinsurance, and that open-ended 20%. Plans are standardized by letter (Plan G and Plan N are the ones people ask about most), so a given letter has the same core benefits no matter which company sells it.

What people tend to like:

• See any doctor or hospital in the U.S. that accepts Medicare — no networks, no referrals. Snowbirds and travelers value this.
• Very predictable costs: after your premium, most covered medical bills are largely taken care of.
• No prior-authorization layer from a private plan; if Medicare approves it, your supplement follows.

What to weigh carefully:

• Monthly premiums are higher than most Advantage plans, and premiums can rise over time.
• Medigap doesn't include drug coverage — you pair it with a standalone Part D plan.
• Your strongest buying window is your Medigap Open Enrollment Period (the six months after Part B starts), when you can't be turned down for health reasons.

Part D: prescription drug coverage

Part D plans cover prescription drugs, either built into a Medicare Advantage plan or as a standalone plan alongside Original Medicare or Medigap. Two things matter more than the premium:

• The formulary — every plan has its own list of covered drugs, sorted into cost tiers. The same medication can cost very different amounts on two different plans.
• The pharmacy network — your pharmacy may be "preferred" on one plan and not on another, which changes your copays.

Side by side

So which path is right for you?

Honestly: it depends, and anyone who answers before asking about your doctors, prescriptions, budget, and travel habits is guessing. There's no single plan that fits everyone — that's exactly why comparing matters.

That conversation is what I do all day. It's free, it takes about 15 minutes to get started, and there's no obligation to enroll in anything.