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How Medicare Works

Learning about Medicare can be a daunting task. But it doesn’t have to be. HAP is here, helping you understand the basics of Medicare (Parts A, B, C and D), the three main types of Medicare (Original, Medicare Advantage, and Supplemental), and the enrollment timeline all the way from signing to switching when a plan doesn’t meet your needs. 

Everyone has different wants and needs. There's no single answer as to which Medicare coverage is best, but HAP can help you find a plan that works for you.

What type of plan should you choose?

Original Medicare Medicare Advantage Medicare Supplement
(Medigap)

Provided by the federal government

Provided by health insurance companies

See HAP's Medicare Advantage plans

Provided by health insurance companies.

See HAP's Medicare Supplement plans.

Helps pay for hospitals and doctors

Helps pay for hospitals, doctors and other services

Helps pay for hospitals, doctors and other services

Includes Parts A & B

No coverage for Part D prescription drugs, dental, hearing or vision

Known as Part C. Includes Parts A & B

Most plans offer Part D prescription drug coverage, dental, hearing or vision

Must be enrolled in Parts A & B

No coverage for Part D prescription drugs, dental, hearing or vision

Must pay 20% coinsurance for most services (once deductible is met)

No limit on out-of-pocket expenses

$0

Many plans require 0-20% coinsurance (once deductible is met)

Out-of-pocket maximums protect you

$0 or more, depending on the plan

Many plans require 0-20% coinsurance (once deductible is met)

Out-of-pocket maximums protect you

Additional monthly premium

If you take prescription drugs, see specialists, or have to visit a hospital, you may wind up paying hundreds or even thousands of dollars out-of-pocket if you only have Original Medicare

Many people select Medicare Advantage plans because prescription coverage is often included and the monthly premiums are usually much lower

For some people (like frequent travelers), the flexibility and benefits that come with Medicare Supplement plans can justify their typically higher premiums

People who sign up for Original Medicare often also purchase a Supplement Plan (Medigap) and a Part D (Rx) plan

People who sign up for this usually only have one plan, as most include drug coverage and you won’t need Medigap

You are only eligible if you have Original Medicare (Parts A & B). People often also sign up for a Part D (Rx) plan

 You will face higher premiums if you don't sign up for Parts A & B on time

Adding Part D later costs more if you don't maintain other equivalent coverage

If you sign up on time for a Medicare Advantage Plan that includes Part D, you will not face any penalties

If you're late, the same penalties apply as with Original Medicare

 If you enroll after the six-month Medigap Open Enrollment Period at age 65, you may be charged more for preexisting conditions or even be turned down
Note: If you choose Original Medicare, a Medicare Supplement plan, or some Medicare Advantage plans, and need drug coverage, you'll need to purchase a separate Medicare Part D plan. Adding drug coverage later will cost more per month.

Why would I need more than Original Medicare?

Health Alliance Plan (HAP) has HMO, HMO-POS, PPO plans with Medicare contracts. HAP Medicare Complete Duals (HMO D-SNP) is a Medicare health plan with a Medicare contract and a contract with the Michigan Medicaid Program. Enrollment depends on contract renewals.