Each worksheet section begins with important information about the differences between the Original Medicare Plan and other Medicare health plans. Your local library or senior center may be able to help you find this information on their computers. In all Medicare health plans, including the Original Medicare Plan, you must pay the monthly Part B premium. In the Original Medicare Plan, you must pay additional costs such as hospital deductibles and coinsurance. The Original Medicare Plan does not pay for prescription drugs.
Costs vary from plan to plan.
In some Medicare health plans, you must get all covered services from doctors and hospitals that belong to the plan. If you are in one of these plans, you may get services from doctors or hospitals outside your Medicare health plan, but you will be responsible for paying for these services. The exception is an emergency, or when you require urgently needed care and are out of the health plan's service area. Write the plan names in the blocks below. Call the Plan.