Medicare Advantage (Part C)
Medicare Advantage plans are Medicare health insurance plans provided by a private insurance company. The insurance company contracts with the Federal Government to pay the claims and administer the benefits for Medicare Parts A and B. These plans must offer benefits as good as Original Medicare but often include extra benefits that Medicare does not cover, as well as Part D (prescription drug coverage). These plans are generally lower in premium with copays or cost-sharing for most procedures. Every plan has an annual maximum out of pocket limit to protect the member from extremely high medical costs.
Medicare Supplement (MEDIGAP)
A Medicare Supplement is available through a private insurance carrier as a supplement to Original Medicare. There are various plan options available, but Plan G is the richest option available to anyone turning 65 after January 1st, 2020. A Medicare Supplement is designed to cover some or most of the out of pocket costs (deductibles, copays and coinsurance) with Original Medicare Parts A and B. These plan options typically do not cover additional benefits beyond what Original Medicare covers, and members will need to enroll in a separate stand-alone Part D (prescription drug) plan.
Part D (Prescription Drug Coverage)
Prescription drug coverage (or Part D) is not available through Original Medicare and must be purchased from a private carrier. This coverage is available as part of a Medicare Advantage plan, or as stand-alone coverage. There is a late enrollment penalty if you do not enroll in Part D within 63 days of going on Medicare. Formularies can vary from plan to plan, so it’s important to choose one that covers all your medications with the lowest out of pocket expenses. We can help you identify which plan option will work best for you.
