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Start with Original Medicare

Original Medicare, a health insurance program managed by the federal government, is for people 65+ or who have certain disabilities. Each part of Original Medicare, Part A and Part B, needs to be purchased separately. Original Medicare will not cover all your Medicare expenses and does not include prescription, dental, vision or hearing coverage.

Part A
Hospital care
Part B
Doctor visits

Next, choose additional coverage

Original Medicare doesn’t cover everything. That’s why most people choose between Medicare Advantage and Medicare supplement, purchased through a private insurance company, in order to get the complete Medicare coverage they need.

Option 1: Medicare Advantage (Part C)

All coverage rolled into one plan

Part A (Hospital)
+
Part B (Doctor)
+
Part D (Drugs)
+
Dental
+
Vision
+
Hearing
+
Gym

 Part A

Part A is covered and paid for by Part C.

Inpatient hospital coverage is free to those who paid Medicare taxes for 10 years; others will pay a monthly premium. Part A covers:

  • Hospital stays and skilled nursing facility care
  • Hospice and some home health care

 Part B 

Part B is covered in Part C, and some Medicare Advantage plans will pay for the Part Bmonthly premium.

Outpatient medical coverage — for doctor visits. A monthly premium External Link is required. Once the deductible is met, you pay 20%. Part B covers:

  • Doctor visits
  • Durable medical equipment (crutches, wheelchair, blood sugar meters, etc.)
  • Outpatient services (such as lab tests)

 Part D

Part D is covered and paid for by Part C.

Drug coverage is included in all Wellmark Advantage Health Plan options.

  • Includes thousands of generic and brand name drugs

Additional included benefits

Wellmark's Medicare Advantage (Part C) plans include:

 Dental
 Vision
 Hearing
 Fitness programs

Option 2: Medicare supplement (Medigap) + Part D

Individual, stand-alone, customized plans

Part A(Hospital)
Part B(Doctor)
Part D(Drugs)
Supplement(Medigap)

 Part A

Inpatient hospital coverage is free to those who paid Medicare taxes for 10 years; others will pay a monthly premium. Part A covers:

  • Hospital stays and skilled nursing facility care
  • Hospice and some home health care

 Part B

Outpatient medical coverage — for doctor visits. You will pay a monthly premium External Link. Once the deductible is met, you pay 20%. Part B covers:

  • Doctor visits
  • Durable medical equipment (crutches, wheelchair, blood sugar meters, etc.)
  • Outpatient services (such as lab tests)

Add-ons to Original Medicare

 Part D

Drug coverage is not included in Original Medicare or Medicare supplement. Even if you don't use medication currently, you should purchase a prescription drug plan through a private insurer as soon as you can enroll to avoid paying a late enrollment penalty External Link.

  • Has a monthly premium
  • May have out-of-pocket costs and a deductible
  • Includes its own list of covered drugs called a formulary

 Supplement

Medicare supplement (Medigap) assists with out-of-pocket costs not covered by Original Medicare.

  • Covers what's left over after Original Medicare pays your claims (deductible, copayment and coinsurance)
  • Includes a monthly premium with various levels of coverage to choose from
  • Gives you the freedom to choose any Medicare provider, anywhere

Wellmark MedicareBlue SupplementSM plans are not connected with or endorsed by the U.S government or the federal Medicare program.

Dental, vision, hearing

Dental, vision and hearing coverage is not included in Original Medicare or Medicare supplement and needs to be purchased separately.

Avēsis Vision is an independent vision insurance company that does not provide Wellmark Blue Cross and Blue Shield of South Dakota products and services. Avēsis Vision is underwritten by Fidelity Security Life Insurance Company, Kansas City, Missouri. Hearing Discount Savings Plan provided by Amplifon. Amplifon is an independent company that does not provide Wellmark Blue Cross and Blue Shield of South Dakota products or services.

Want to see more differences between Medicare Advantage vs. supplement?

Now that you understand the basic differences between Original Medicare, Medicare Advantage and Medicare supplement, see which coverage is right for you.

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Working Past 65?

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Get your questions answered

Still have questions?

If you'd rather talk to someone to get your questions answered about your options in Iowa or South Dakota, call a Medicare expert, at no cost.

1-800-336-0505 click to call

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