Medicare Health Plan Options
Medicare Supplement Insurance Plans
Helps fill in the gaps left behind by Original Medicare
Most popular Medicare Supplement Plan Types include Plan G, Plan F, and Plan N
All plans are standardized and usually have very small out-of-pocket costs
A Medicare Supplement or Medigap, is a private plan offered by insurance companies and helps to pay for most of your out-of-pocket costs like copays, deductibles, and premiums. This plan picks up where Original Medicare stops. Medicare Supplements are standardized plans in 47 states, while three states – Massachusetts, Minnesota, and Wisconsin have their own customized plans. The standardized Medigap plans are marked by letters of the alphabet – A, B, C, D, F, G, K, L, M, and N. Once enrolled in a Medicare Supplement, your plan will cover the portion of your bill, once Original Medicare has paid its claims. Medicare Supplements do not cover prescription drugs plans. Medicare Supplements can only be used with Original Medicare Part A & Part B.
Medicare Advantage Insurance Plans
Offers the same benefits as Original Medicare Part A & Part B
Variety of plan options including HMO/PPO networks, and $0 premium special needs plans
Most plans include Medicare Part D Prescription Drug coverage
Medicare Advantage is another name for Medicare Part C and provides the same benefits as Original Medicare Part A & Part B, with the exception of hospice care, a service covered by Part A. Medicare Advantage plan members will continue paying their Part B premium in addition to the monthly premium set by the private insurance company. Many Medicare Advantage plans offer Part D, which covers prescription drugs. This plan offers doctor visits, hospital stays, and other health care providers within a network. Medicare Advantage plans also usually require co-pays and deductibles. Unlike Original Medicare Part A & Part B, these payments put annual limits on how much you pay out-of-pocket. Once you’ve reached the set limit, the plan will cover your medical expenses for the rest of the year. This means you won’t have to pay any more after reaching the spending limit. Medicare Advantage plans often include additional benefits such as transportation, gym memberships, dental, vision, and hearing coverage and more.
Medicare Part D Prescription Drug Plans
Covers costs of prescription drugs
Stand-alone plans offered by private insurance companies
Every plan includes deductibles, premiums, copays, and coinsurance
Medicare Part D encompasses a variety of drug plans. These plans cover its own set of drugs listed on a formulary. The cost of drug plans varies based on which types of drugs you need and whether you participate in the plan’s network pharmacy. There is also no standard monthly premium for Part D, as it varies by the private insurance company which sets premiums each year. The stand-alone Medicare Part D plans provide drug coverage only and are used by beneficiaries that come from the Original Medicare program. These plans can be used with Medicare Supplements. Most individuals enrolled in Medicare Advantage plans already have existing prescription drug coverage within their plan. Medicare Part D has a coverage gap that strongly affects out-of-pocket prescription drug costs, this is known as the Part D donut hole. The donut hole puts a restriction on how much your Part D plan will pay for covered drugs. Beneficiaries in the donut hole pay higher percentages for both brand name and generic drugs.
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