Original Medicare is coverage managed by the federal government. Generally, there's a cost for each service. In most cases, yes. You can go to any doctor, health care provider, hospital, or facility that is enrolled in Medicare and accepting new Medicare patients. With few exceptions, most prescriptions are not covered in Original Medicare. You can add drug coverage by joining a Medicare Drug Plan (see more on this under Part D Prescription plans). You generally pay a set amount for your health care (deductible) before Medicare pays its share. There is no yearly limit for what you pay out-of-pocket. A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare.

MAPD plans provide Part A and Part B Medicare benefits and in California they include Part D prescription coverage as well. These plans can include HMO’s (Health Maintenance Organizations), PPO’s (Preferred Provider Organizations), PFFS (Private Fee-for-Service Plans), SNP’s (Special Needs Plans), CSNP’s (Chronic Special Needs Plans). If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and are not paid for under Original Medicare. There is a cap for out of the pocket expenses, which varies from plan to plan.

Medicare Advantage Plans provide services that fall under Part A, Part B and Part D benefits to those enrolled. Additionally, there is typically some coverage for transportation, vision, dental, hearing and other medicare support needs that may arise.

The amount you pay for your Part B Medicare is based on your specific financial situation and determined by Social Security. With most Medicare Advantage Plan there is no additional cost for the plan itself.

Yes. Sometimes there is a copay with a provided service, however, many of the services have a zero-dollar copay. Copays differ from plan to plan, so it is important to discuss with your agent your medicare history; this way he can recommend to you the plan that will best meet your specific needs.

Under the Part D benefit, you get prescription drug coverage through the MAPD plan. Typically, the copay is zero dollars for tier 1 and 2 prescription drugs. There can be some cost to the individual for prescription drugs that fall under Tier 3, 4 and 5.

The Centers for Medicare & Medicaid Services (CMS) is the agency within the U.S. Department of Health and Human Services (HHS) that administers the nation’s major healthcare programs. The CMS oversees programs including Medicare, Medicaid, CHIP (Children’s Health Insurance Program), and the state and federal health insurance marketplaces. CMS releases updated Medicare premium and deductible information each year. CMS pays a fixed amount for your care each month to the companies that offer the MAPD plans. These companies much follow the rules set by Medicare.