Medigap, Medicare Advantage, and Medicare Part D Coverage Explained for the Overwhelmed.
Selecting a Medicare plan that will best fit your needs can be an overwhelming process. There are so many different plans to choose from. Private insurance carriers offer several different Medicare plan options that complement or replace original Medicare. If you find yourself overwhelmed, the team at Senior65.com can answer your questions and assist with enrollment. There is never a fee for our services. Below is an overview to get you started.
First, Let’s start with the basics
Original Medicare
Once you are enrolled in Medicare part A and B, you can start exploring additional coverage options, like Medicare Supplemental (AKA Medigap), Medicare Advantage (AKA MA), or Part D plans.
Medigap Insurance Coverage
Medicare supplement plans help pay for some of the services that are not covered by original Medicare parts A and B. They “fill in the gaps” to help pay deductibles and co-insurance not covered by original Medicare. These plans are regulated by Medicare and sold by private insurance carriers. These policies protect you from high out-of-pocket costs that could be incurred if you received medical treatment under original Medicare.
Medicare supplement plans have standardized benefits, such as Plans A, B, C, G, F, L, K, N, etc. At Senior65.com, we find most people who become Medicare eligible after 2020 purchase Plan G, high deductible G, or Plan N.
Medigap plans do not have a specific network of doctors, therefore, you can see any doctor nationwide that accepts Medicare. Learn More about Medigap here.
Get a Medigap Quote Enroll in Medigap
Medicare Advantage
Medicare Advantage plans are offered by private insurance companies, who must follow rules set by Medicare, sometimes you will hear them referred to as “Part C” or “MA” plans. These plans can be purchased once you are enrolled in original Medicare parts A and B (and not enrolled in a separate Medicare prescription drug or Medigap plan).
Medicare Advantage plans replace original Medicare, and at a minimum, offer equivalent benefits. They aim to help cover medical expenses, routine doctor visits, and often include coverage for prescription drugs.
There are multiple types of Medicare Advantage plans to consider including, PPOs, HMOs, and private fee-for-service plans, (whose networks are typically smaller than Medicare’s national network).
Medicare Advantage plan premiums vary based on plan selection and region. One way to reduce costs is to select a zero premium plan. For example, if you enroll in a plan that has a $0 premium, you will only have to pay your Medicare Part B amount, you will not have any extra costs for the Medicare Advantage plan. Some zero premium plans include gym memberships, prescription drug coverage, and discounts for vision and hearing. Learn More about Medicare Advantage here.
Learn More about Medicare Advantage Get a MA Quote
Medicare Part D Drug Coverage
The “Part D” of Medicare, is prescription drug coverage, just remember D is for drugs! There are four main types of part D plans: PDPs (Prescription Drug Plans), MA-PDs (Medicare Advantage-Prescription Drug plans), Medicare Cost Plan, and MSPs (Medicare Special Needs Plans).
Part D premiums vary based on the plan’s specific details. For instance, a higher priced plan may have lower co-payments for more expensive medications, but this is not always the case. Purchasing a lower-priced plan does not mean it won’t cover as many drugs as a more expensive plan. The key is to enter your current medications before enrolling in a plan, so you can see how much your refill costs will be. If you need help, Senior65.com, can assist.
Most drug plans have a deductible, this amount varies from one plan to the next. The deductible must be paid before the plan starts to pay, typically; low-tiered (generic) medications are not subject to the deductible.
Most of the drug plans have pharmacies they partner with, when you use a preferred pharmacy, it allows you to pay a lower amount for your refills. If you choose not to use a preferred pharmacy, you will likely pay more for your refills. Learn more about part D drug plans here.
According to the Social Security Administration, if you have lower income, you may qualify for extra help paying your monthly premiums.
Next Steps with Medicare Insurance
1) Learn more about Medigap, Medicare Advantage, and Part D drugs
2) Once you know what plan you are interested in Get an instant quote here
3) Enroll online or Contact Senior65.com at 800-930-7956 to enroll over the phone.