Medicare

What is Medicare?

Medicare is a federal health insurance program primarily for people aged 65 and older, though it also covers certain younger individuals with disabilities or specific medical conditions. It helps pay for hospital stays, doctor visits, preventive services, prescription drugs, and more, depending on the coverage you choose.

Medicare is divided into different parts:

• Part A covers hospital care.
• Part B covers outpatient services like doctor visits and preventive care.
• Part C (Medicare Advantage) also known as Part C provides the same benefits as Original Medicare (Part A and Part B), and often includes Part D (prescription drug coverage), all in one plan.
• Medicare Supplement Plans: also known as Medigap plans are designed to fill in the gaps in Original Medicare's coverage. The plan are lettered A-N and the benefits are standardized by CMS.The Guaranteed Issue Period allows you to enroll in any Medigap policy even with pre-existing conditions if you enroll within six months from enrolling in Part B. Medigap plans cannot be cancelled by the insurance company as long as the premium is paid. Some plans offer additional benefits e.g., travel and ancillary benefits.
• Part D helps cover some of the cost of prescription drugs although co-pays and deductibles may apply.

Understanding your Medicare options can help you make the best decisions for your health and budget.

What Is Medigap (Medicare Supplement Insurance)?

Medigap, also known as Medicare Supplement Insurance, is a type of private insurance that helps cover the "gaps" in Original Medicare (Parts A and B). These gaps include out-of-pocket costs like copayments, coinsurance, and deductibles.

Medigap plans are offered by private insurance companies and are standardized across most states, meaning the benefits of each plan type (Plan A, Plan G, Plan N, etc.) are the same no matter which company offers it—only the price may vary.

Key Features of Medigap:

• Helps reduce your out-of-pocket costs
• You can keep your Medicare doctor and hospital choices
• No referrals needed to see a specialist
• No networks constraints
• You can access care nationwide
• Works only with Original Medicare (not Medicare Advantage)
• Guarantee Issue when turning 65 and/or triggering Part B

Medigap does not cover prescription drugs, so you’ll also need a separate Medicare Part D plan for drug coverage.

What Is Medicare Part D?

Medicare Part D is prescription drug coverage offered through private insurance companies approved by Medicare. It helps cover the cost of prescription medications, bringing down what you pay out of pocket.

Part D is available to anyone enrolled in Medicare Part A and/or Part B. You can get coverage through a stand-alone Part D plan or as part of a Medicare Advantage Plan (Part C) that includes drug coverage.

What Medicare Part D Covers:

• Prescription drugs (both generic and brand-name)
• Many common medications used to treat chronic conditions
• Certain vaccines

TIP: Plans may vary in cost, covered drugs, and which pharmacies you can use, so it’s important to compare your options and choose a plan that meets your needs. It is also important to enroll within the enrollment windows in order to avoid penalties.

Contact us today to help guide you thru this important decision!