Medicare Plans

Types of Medicare Plans

Medicare Supplement

Medicare supplements, also called Medigap insurance, are for those that want to keep the freedom and control of Original Medicare, but without the financial exposure. These supplements fill in the the financial gaps left with Original Medicare. There are 10 Medigap plans, each with different outlines of coverage. They are designated as Plans A, B, C, D, F, G, K, L, M, N. The vast majority of people in 2023 utilize Plan G or N.

While these plans do not provide for prescription drugs, they do provide unmatched coverage for all other major medical services.

Important note to remember: The coverage provided by each letter plan is determined by the government, not the insurance carriers. A Plan G or Plan N will offer the exact same coverage – whether on Aetna, Humana, or Mutual of Omaha – by law.

Medicare Advantage

Medicare Advantage (Part C) plans are provided by Private insurance companies. These plans replace the coverage provided by Original Medicare (Part A & B) with many additional benefits. Advantage plans are highly regulated to be actuarially equivalent to Original Medicare, but there are tradeoffs. With Original Medicare, you have total control of your healthcare and total freedom to go to almost all doctors or hospitals in the U.S., but you also have a Part A deductible and Part B 20% coinsurance (that has no ceiling). With Medicare Advantage, these are replaced with small copays and you have a maximum out of pocket to serve as a stop gap.

Medicare Advantage include a regional network of providers (e.g. HMO or PPO plans). Depending on where you live, many plans include additional benefits not part of Original Medicare.

Prescription Drug Plan

Part D plans are federally funded prescription drug plans administered through private insurance companies. Medicare beneficiaries may supplement Original Medicare by enrolling in a stand-alone Part D plan, or they may get Part D coverage as part of a Medicare Advantage plan.

Part D plans are famous for having a “donut hole”, a coverage gap between their initial coverage max and their catastrophic coverage.

These plans are specific to networks of doctors and pharmacies. It is important to shop the plans with your list of medications and preferred pharmacy to make sure you have the coverage for your scenario.

Reach out and let us walk you through making the best decision for your prescription drug coverage.

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Do you know your Medicare Lingo?

  • Premium

    The amount paid to an insurance company for offered health coverage.

  • Maximum Out of Pocket

    The maximum amount spent before medical bills are covered 100%.

  • Deductible

    The amount paid before insurance pays.

  • Copay

    A set amount owed contributed toward the cost of medical care