Medicare — My Mom’s Version

Here’s how she laid it out.

Grab your coffee — this is the notepad version.

“Medicare only looks complicated,” Mom said, “because everybody tries to build their own out of the pieces. You don’t. There are two doors. You pick one. The door you pick decides what’s on your plate — and once you see that, the whole alphabet stops being scary.”

So let’s open both doors. And unlike the game show, nobody’s hiding a goat behind one of them — you get to see exactly what’s back there before you choose.

Door Number One — Original Medicare

This is the government’s own program — the one Mom was on for twenty-some years. Two pieces do the heavy lifting:

• Part A is the hospital. Your inpatient stays, skilled nursing after a hospital stay, and hospice.
• Part B is the doctor. Office visits, outpatient care, lab work, the flu shot, the walker.

The big thing folks love about Door One is freedom: you can walk into any doctor or hospital in the country that takes Medicare — and nearly all of them do — with no network and no referral.

Here’s the catch Mom was honest about: Original Medicare doesn’t pay 100%. It leaves deductibles and a slice of every bill (usually about 20%), and there’s no cap on that slice by itself. So most people behind Door One add two things on the side:

• A Medigap policy to cover most of those leftover costs, and
• A Part D plan for prescriptions.

More freedom, a steadier monthly cost, a little more mail.

Door Number Two — Medicare Advantage

Behind Door Two is one bundled plan from a private insurance company that stands in for Original Medicare. Same Medicare underneath — a different way of delivering it. What you get:

• One card, one plan that usually rolls hospital (Part A), doctor (Part B), and drugs (Part D) together.
• Extras Original Medicare doesn’t cover on its own — often dental, vision, hearing, sometimes a gym membership.
• A yearly out-of-pocket maximum, so your spending has a ceiling.
• A premium that’s frequently low — sometimes $0 on top of your Part B.

The trade-off Mom would want me to say out loud: you work inside a network of doctors and hospitals, and you may need a referral or a prior approval before certain care. You trade a little freedom for a lower monthly cost and one simple plan.

Door One vs. Door Two, at a glance

The one rule that untangles everything

You can’t stand in both doorways at once.

If you choose Medicare Advantage (Door Two), you can’t also carry a Medigap policy — they’re two different systems and they don’t stack. That’s what “you don’t build your own” really means. You pick a door, and the rest follows.

(You can switch doors later, at the right times of year — but at any one moment, you’re standing in one doorway, not both.)

The two alphabets

This is the one nobody warns you about, and it’s the reason sharp people feel foolish reading Medicare booklets. There are two different alphabets.

• The Parts — A, B, C, D — are the pieces of Medicare itself. A is hospital. B is doctor. D is drugs. C is the sneaky one: Part C isn’t a piece you add on — it’s the whole of Door Two.
• The Plans — A, B, G, N, and the rest — are something else entirely. Those are the Medigap policies you can add behind Door One to cover what Original Medicare leaves on the table.

So “Part B” and “Plan G” aren’t even in the same alphabet. Mixing them up is like confusing Chapter 2 with Aisle 2. Once you know there are two lists, half the fog burns off.

The Medigap letters, in plain English

Don’t memorize this. Nobody expects you to. Most folks end up choosing between just two — Plan G and Plan N — and the rest are here so you can see the whole board.

In most states, any two policies with the same letter cover the same things; the price is what changes from company to company. (Massachusetts, Minnesota, and Wisconsin do it a little differently.)

Source: Medicare.gov — Compare Medigap Plan Benefits. Dollar figures shown are for 2026.