Let us find you the best policy to fill the gaps in your Medicare coverage. Coverage that allows you to go to any doctor or any hospital. You can purchase a plan that would have no deductibles, no co-pays, and no co-insurance.
A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that Original Medicare doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will both pay their shares of covered health care costs.
Medigap policies must follow Federal and State laws and have specific benefits so you can compare them easily. A Medigap policy must be clearly identified on the cover as “Medicare Supplement Insurance.” Each plan, A through N, has a different set of basic and extra benefits.
It’s important to compare Medigap policies because costs can vary. The benefits in any Medigap Plan A through N are the same for ANY insurance company. Each insurance company decides which Medigap policies it wants to sell.
Your Medigap policy won’t cover any health care costs for your spouse.
Medicare Advantage Plans
These plans generally get all your Medicare-covered health care through the plan and can include prescription drug coverage. Medicare Advantage Plans include:
- Medicare Health Maintenance Organization (HMOs)
- Preferred Provider Organizations (PPOs)
- Medicare Special Needs Plans
When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your health care. These plans sometimes offer extra benefits and lower copayments than in the Original Medicare Plan. However, you may have to see doctors that belong to the plan or go to certain hospitals to get services.
To join a Medicare Advantage Plan, you must have Medicare Part A and Part B.
If you join a Medicare Advantage Plan you want to drop your Medigap policy since you can’t be covered under two policies at the same time.
Prescription Drug Coverage (Part D)
Medicare prescription drug coverage is insurance that covers both brand-name and generic prescription drugs at participating pharmacies in your area. Part D provides protection for people who have very high drug costs or from unexpected prescription drug bills in the future.
Everyone with Medicare, regardless of income, health status, or prescription drugs used, can get prescription drug coverage. You may sign up for Part D when you first become eligible for Medicare (three months before the month you turn age 65 until three months after you turn age 65). If you get Medicare due to a disability, you can join from three months before to three months after your 25th month of cash disability payments. If you don’t sign up when you are first eligible, you may pay a penalty. If you didn’t join when you were first eligible, your next opportunity to join will be from October 15th to December 7th.
Your decision about Medicare prescription drug coverage depends on the kind of health care coverage you have now. There are two ways to get Medicare prescription drug coverage. You can join a Medicare prescription drug plan or you can join a Medicare Advantage Plan or other Medicare Health Plan that offers drug coverage. Medicare prescription drug coverage provides greater peace of mind by protecting you from unexpected drug expenses. Even if you don’t use a lot of prescription drugs now, you should still consider joining. As we age, most people need prescription drugs to stay healthy. For most people, joining now means protection from unexpected prescription drug bills in the future.
Whatever plan you choose, Medicare drug coverage will help you by covering brand-name and generic drugs at pharmacies that are convenient for you.
Like other insurance, if you join, generally you will pay a monthly premium, which varies by plan, and a yearly deductible. You will also pay a part of the cost of your prescriptions, including a copayment or coinsurance. Costs will vary depending on which drug plan you choose. Some plans may offer more coverage and additional drugs for a higher monthly premium. If you have limited income and resources, and you qualify for extra help, you may not have to pay a premium or deductible. You can apply or get more information about the extra help by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or by visiting www.socialsecurity.gov on the web.