Confused by Medicare?

You are not alone.

What is the difference between Medicare Supplemental Insurance (Medigap) and Medicare Advantage Plans? If you would like to understand how the different parts of Medicare work together schedule a private telephone discussion or attend one of our Medicare Educational Meetings. We will go over Part A, Part B, Part C, Part D and Medicare Supplement Insurance (Medigap) Plans. After the discussion you will have a better understanding of how Medicare works and how to make an informative choice.

To schedule a time to speak with a licensed, certified and appointed agent, click on the calendar.

Or Call 800-641-3315

Original Medicare which is administered directly by the federal government has two parts:

Part A (Hospital Insurance)

Part A has deductibles and co pays, it does cover most medically necessary hospital, skilled nursing facility, home health and hospice care. If you have worked and paid Social Security taxes for at least 40 calendar quarters (10 years) you will not have a premium.

Part B (Medical Insurance) 

Part B has deductible and co pays, it covers 80% of most medically necessary doctors’ services, preventive care, durable medical equipment, hospital outpatient services, laboratory tests, x-rays, mental health care, and some home health and ambulance services. You pay a monthly premium for this coverage.

If you are still working or need to apply for Original Medicare On-line the web site to apply is:  https://secure.ssa.gov/iClaim/rib It does have a short video to show you how to apply.

Part C Medicare Advantage Plans

A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage. Learn more about Medicare Advantage Plans here.

Medicare Part D (outpatient Prescription Drug Insurance)

Medicare offers prescription drug coverage through private insurance companies to everyone with Medicare. If you decide not to get Medicare drug coverage when you’re first eligible, you’ll likely pay a late enrollment penalty unless one of these applies:

  • You have other creditable prescription drug coverage
  • You get Extra Help

To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered. Learn more about Medicare Part D here.

You may owe a late enrollment penalty if, for any continuous period of 63 days or more after your Initial Enrollment Period is over, you go without one of these:

  • A Medicare Prescription Drug Plan (Part D)
  • A Medicare Advantage Plan (Part C)  (like an HMO or PPO)
  • Another Medicare health plan that offers Medicare prescription drug coverage
  • Creditable prescription drug coverage

2 ways to get drug coverage

  1. Medicare Prescription Drug Plan (Part D). These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
  2. Medicare Advantage Plan (Part C)(like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage. You get all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.

What’s Medicare Supplement Insurance (Medigap)?

A Medicare Supplement Insurance (Medigap) policy helps pay some of the health care costs that Original Medicare doesn’t cover, like:

  • Co payments
  • Coinsurance
  • Deductibles

Medigap policies are sold by private companies.

Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, here’s what happens:

  • Medicare will pay its share of the Medicare-approved amount for covered health care costs.
  • Then, your Medigap policy pays its share.

To schedule a private call with a licensed sales agent to become informed about Medicare Advantage Plans, Medicare Supplement  Insurance Plans, and/or Prescription Drug Plans.

woman holding a calendar

or Call 800-641-3315

 

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