Choose Your Path

Now that you have an understanding of what Medicare is and how it works, it’s time to start making decisions on which path will provide you with the coverages and benefits you need. When you first enter Medicare, you’ll have the option to choose basically one of two paths, Original Medicare or Medicare Advantage.

Which path you choose won’t necessarily be permanent as there are opportunities each year to make necessary changes as your situation and needs change. You may remember the different enrollment periods we covered earlier.

Now that you have an understanding of what Medicare is and how it works, it’s time to start making decisions on which path will provide you with the coverages and benefits you need. When you first enter Medicare, you’ll have the option to choose basically one of two paths, Original Medicare or Medicare Advantage..

Which path you choose won’t necessarily be permanent as there are opportunities each year to make necessary changes as your situation and needs change. You may remember the different enrollment periods we covered earlier.

Original Medicare

  • Parts A & B

  • 80 / 20 Plan

  • National Coverage

  • No Referrals

  • 20% Uncapped Coinsurance

  • Prescriptions not Included

Optional Benefits

  • Medigap Policy

  • Prescription Drug Plan

  • Dental, Vision, Hearing

  • Critical Illness

Medicare Advantage

  • Part C

  • All-in-one Plan

  • Network Coverage

  • Referral Requirements

  • Varying Copayments

  • Prescriptions Available

Optional Benefits

  • Dental, Vision, Hearing

  • Hospital Indemnity

  • Critical Illness

  • Short Term Care

Original Medicare Path

  • Parts A & B

  • 80 / 20 Plan

  • National Coverage

  • No Referrals

  • 20% Uncapped Coinsurance

  • Prescriptions not Included

Optional Benefits

  • Medigap Policy

  • Prescription Drug Plan

  • Dental, Vision, Hearing

  • Critical Illness

- OR -

Medicare Advantage Path

  • Part C

  • All-in-one Plan

  • Network Coverage

  • Referral Requirements

  • Varying Copayments

  • Prescriptions Available

Optional Benefits

  • Dental, Vision, Hearing

  • Hospital Indemnity

  • Critical Illness

  • Short Term Care

Those are your two primary options, and on the following page we’ve outlined some benefit packages you may want to consider as you begin to outline your needs.

To help you better understand these benefit packages here are a few quick reminders and definitions:

Those are your two primary options, and on the following page we’ve outlined some benefit packages you may want to consider as you begin to outline your needs.

To help you better understand these benefit packages here are a few quick reminders and definitions:

Original Medicare – Parts A & B; your national 80/20 plan.

Coinsurance - Your shared costs for any covered expense, usually expressed in a percentage.

Copayment - Your shared cost for any covered expense, usually expressed in a flat dollar amount.

Deductible - A specified amount of money that you must pay before your plan will begin paying.

Medigap Policy – Private insurance plan designed to help cover the coinsurance gap in Original Medicare

PDP – Stand-alone Prescription Drug Plan to help cover costs for medications filled at a pharmacy.

Dental, Vision, Hearing (DVH) Plan – Private plan covering dental, vision, and/or hearing needs.

Critical Illness – Provides a cash benefits upon diagnosis of a specific critical illness like cancer, heart attack or stroke.

Medicare Advantage Plan – A private, network-driven alternative to Original Medicare.

Hospital Indemnity – Provides cash benefits for overnight stays as an inpatient in the hospital or skilled nursing facility.

Short Term Care - Provides cash benefits for up to 365 consecutive days of skilled nursing or home health care.

Final Expense – A whole life Insurance policy designed to cover funeral expenses and more.

Original Medicare – Parts A & B; your national 80/20 plan.

Coinsurance - Your shared costs for any covered expense, usually expressed in a percentage.

Copayment - Your shared cost for any covered expense, usually expressed in a flat dollar amount.

Deductible - A specified amount of money that you must pay before your plan will begin paying.

Medigap Policy – Private insurance plan designed to help cover the coinsurance gap in Original Medicare

PDP – Stand-alone Prescription Drug Plan to help cover costs for medications filled at a pharmacy.

Dental, Vision, Hearing (DVH) Plan – Private plan covering Dental, Vision, and/or Hearing needs.

Critical Illness – Provides a cash payment upon diagnosis of a specific critical illness like cancer, heart attack or stroke.

Medicare Advantage Plan – A private, network-driven alternative to Original Medicare.

Hospital Indemnity – Provides cash payment for overnight stays as an inpatient in the hospital or skilled nursing facility.

Short Term Care - Provides cash benefits for up to 365 consecutive days of skilled nursing or home health care.

Final Expense – A whole life Insurance policy designed to cover funeral expenses and more.

This is a proprietary website and is not associated with, endorsed, or authorized by Medicare or the federal government.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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DBA "Avila Medicare Solutions"

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Cedar Park, Texas 78613

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