Medicare

Before choosing a plan we want to be sure you know the difference between your many options; In particular how Medicare Supplements Insurance and Medicare Advantage Plans differ. Many people sign up for Advantage Plans thinking they are Medicare Supplement Insurance, they are not.

A Medicare Supplement Insurance is used with original Medicare. Any caregiver that accepts Medicare will take a Medigap because they only need to bill Medicare. Medicare pays their part (generally 80% of Medicare covered benefits) and sends the remainder of the bill to the Medigap which pays their part (generally 20%). It is important to note that Medigap do NOT include Prescription Drug Coverage (Part D, PDP) and for those that do not get a PDP when first eligible, there may be a penalty when they do get a PDP (there are exceptions to this).  Medicare Supplement Insurance coverage does not generally change year to year (although the preiums may change annually).

   
  

A Medicare Advantage plan works differently than a Medigap. With a Medicare Advantage Plan a private company TAKES OVER for Medicare (you remain in the Medicare system but Medicare is no longer responsible for your bills). These plans follow the same type of model as many group plans such as HMO or PPO. With this type of plan, it is important to remember several things. First, most Advantage Plans have Networks, so you want to make sure your Doctor, Hospital, and auxiliary care are within the network. (otherwise you may be paying higher costs and in some cases are responsible for 100% of care outside the network) Second, Advantage Plans have co-pays associated with them. It is important to be aware of these because they can add up to be quite a bit of money. Third, most Advantage Plans have the Part D “built in” which is a nice bonus but you must be aware that when switching to a Medigap from an Advantage Plan you will also need to add a Part D.

Also, not all Plan D Prescription plans are the same. Although they are required to be at least as good as the Medicare model they can vary greatly in costs, co pays and specific drugs that are covered. It is important to check which one suits you and continue to check each year because they (like Advantage Plans) do change every year.

Because these plans may vary, even from county to county, we suggest that you contact us to help you choose the one that best suits your needs.

 
     
 
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