Medicare Basics | Wellcare

Learn more about your Medicare Advantage options.

Getting started with Medicare.

If you’re turning 65 or just need a better understanding of Medicare basics, watch this video.

COVERAGE	ORIGINAL MEDICARE (Parts A & B)	STAND-ALONE PRESCRIPTION DRUG PLAN (Part D)	MEDICARE ADVANTAGE PLAN (Part C)
$0 or low monthly plan premium
Doctor and hospital coverage
Prescription drug coverage
Dental coverage
Vision coverage
Hearing coverage

Original Medicare: Parts A & B

Original Medicare is managed by the federal government and is just a starting point for your health care.

Part A covers in-patient medical hospital care, nursing facilities, hospice, and some home health care.

Part B helps cover doctor visits, outpatient care, and some preventive services.

You usually pay a monthly premium and must meet yearly deductibles

Covers 80% of the approved amount and you're responsible for the remaining 20%

Most prescription drugs, and routine dental care are not covered

No limit on yearly out-of-pocket costs

Medicare Advantage: Part C

Medicare Advantage is offered by private insurers and combines the benefits of Parts A & B plus other potential benefits, like vision, dental, hearing and much more.

Maximum out-of-pocket limit per plan year means 100% of allowed healthcare costs after you meet your out-of-pocket limit

Helps you control and understand your financial risk

Some plans include Part D (prescription) coverage, fitness benefits, and FREE over-the-counter health care items

Understanding the Value of Medicare Advantage plans.

When it comes to understanding the value of Medicare Advantage plans, you may have questions. Wellcare is here to help from the start. Learn more about your Medicare options in this quick video.

Common Types of Medicare Advantage Plans

Health Maintenance Organization (HMO)

Usually requires you to get most care and services from in-network providers

Costs are lower with in-network providers

Must choose a Primary Care Provider (PCP)

Need referrals to see a specialist

Learn More

Preferred Provider Organization (PPO)

Provide you with a preferred network

Costs are lower with in-network providers

Costs are generally higher with out-of-network providers

Probably won’t need a referral to see a specialist

Learn More

Dual Eligible Special Needs Plans (D-SNP)

Designed to coordinate covered benefits and services if you qualify for both Medicare and Medicaid

Learn More

Medicare Advantage and Prescription Drug Coverage: Part D

If you rely on prescription drugs to maintain your health, you have several options for prescription drug coverage:

Some Medicare Advantage (Part C) plans include prescription drug coverage (MAPD)

If you have Original Medicare (Part A & B), you can purchase a Prescription Drug Plan (PDP)

Includes mail-order service to help you save money and time

You may need to pay a deductible

Discount programs and subsidies are available for those with qualifying income

Stages of Coverage

01Deductible:

The amount you pay before a plan covers your prescription drug costs, if applicable.

02Initial Coverage:

The plan pays its share of the cost, and you pay your share. This stage lasts until your payments and the plan’s payments total $2,000 for the year.

03Catastrophic Coverage:

Once your out-of-pocket costs for prescription drugs reach $2,000, you are no longer required to share costs beyond your plan co-pays for covered generic and brand name drugs.