Medicare for 65+ and Disabled
Medicare Supplement plans, also known as Medigap plans, are private insurance plans that are designed to help cover some of the out-of-pocket costs that are not covered by Original Medicare.
Medicare Supplement plans are available to individuals who are enrolled in Medicare Parts A and B. These plans are sold by private insurance companies and are standardized by the federal government. This means that each plan must provide the same benefits, regardless of which insurance company sells it.
There are ten different Medicare Supplement plans available, labeled with letters from A to N. Each plan offers different levels of coverage, with Plan A being the most basic and Plans F and G providing the most comprehensive coverage.
Some of the common benefits offered by Medicare Supplement plans include coverage for Medicare Part A and B deductibles, coinsurance, and copayments, as well as coverage for certain services that are not covered by Original Medicare, such as foreign travel emergency care.
It’s important to note that Medicare Supplement plans do not cover prescription drugs. For that, you would need to enroll in a separate Medicare Part D plan.
Medicare Supplement plans can be a good option for those who want predictable out-of-pocket costs and more comprehensive coverage than what Original Medicare provides. However, they can also be more expensive than other Medicare options, so it’s important to shop around and compare plans to find the one that best fits your needs and budget.
Stand-alone Medicare Prescription Drug Plans
Stand-alone Medicare Prescription Drug Plans (also known as Medicare Part D plans) are private insurance plans that help cover the cost of prescription drugs. These plans are available to individuals who are enrolled in Medicare Parts A and/or B, and are offered by private insurance companies that have contracts with the federal government.
Medicare Part D plans have a formulary, which is a list of prescription drugs that the plan covers. Each plan’s formulary may differ in terms of which drugs are covered, and at what cost. However, all plans are required to cover a minimum set of drugs, as determined by Medicare.
Each Medicare Part D plan has a monthly premium, which varies depending on the plan and the individual’s location. Additionally, there may be deductibles, copayments, and coinsurance for prescription drugs, which also vary depending on the plan and the drug.
It’s important to note that individuals who are enrolled in a Medicare Advantage plan that includes prescription drug coverage (also known as a Medicare Advantage Prescription Drug plan) do not need to enroll in a separate Medicare Part D plan.
Choosing the right Medicare Part D plan can be complex, as there are many different plans with different formularies and costs. It’s important to review your prescription drug needs and compare plans to find the one that best fits your needs and budget. The Medicare Plan Finder tool, available on the Medicare website, can help you compare plans in your area.
Medicare Advantage Plans
Medicare Advantage plans, also known as Medicare Part C, are private insurance plans that provide an alternative way to receive Medicare benefits. These plans are offered by private insurance companies that have contracts with the federal government.
Medicare Advantage plans are required to provide at least the same level of coverage as Original Medicare (Parts A and B). However, many Medicare Advantage plans offer additional benefits, such as prescription drug coverage, dental and vision care, and wellness programs. Some plans also offer benefits like transportation to medical appointments and meal delivery.
Unlike Original Medicare, which pays healthcare providers directly for the services they provide, Medicare Advantage plans pay a fixed amount per enrollee to the insurance company. In turn, the insurance company provides the benefits covered under the plan.
It’s important to note that Medicare Advantage plans often have network restrictions, meaning that you may be limited to using healthcare providers within the plan’s network in order to receive coverage. However, many plans offer out-of-network coverage for emergencies or urgent care.
Medicare Advantage plans have an annual out-of-pocket limit, which is the maximum amount that you would be responsible for paying for covered services in a given year. This can provide some financial protection against unexpected healthcare costs.
Choosing the right Medicare Advantage plan can be complex, as there are many different plans with different benefits and costs. It’s important to review your healthcare needs and compare plans to find the one that best fits your needs and budget. The Medicare Plan Finder tool, available on the Medicare website, can help you compare plans in your area.