Medicare Advantage Plans
Due to the overwhelming costs of healthcare, and the amounts that Original Medicare does not cover, most people choose to have some kind of additional coverage. You may have EITHER a Medicare Advantage Plan OR a Medicare Supplement (Medigap) plan. You may not have both.
Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you're in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you're always covered for emergency and urgently needed care.
The plan can choose not to cover the costs of services that aren't medically necessary under Medicare. If you're not sure whether a service is covered, check with your provider before you get the service.
Medicare Advantage Plans may offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Most includeMedicare prescription drug coverage (Part D). In addition to your Part B premium of $144.60*, some plans charge a monthly premium for the Medicare Advantage Plan. There are also a selection of low and Zero Premium Medicare Advantage Plans.
*Most people pay a monthly part B premium of $144.60. See part B page for more details. https://www.medicarestart.com/medicare-part-b
Medicare Supplement Plans
A Medicare Supplement Insurance (Medigap) policy helps pay some of the health care costs that Original Medicare doesn't cover, like:
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Copayments
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Coinsurance
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Deductibles
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Medigap, or Medicare Supplement policies are sold by private companies. The monthly premiums are on top of your part B premium, $144.60* for most, which must always be paid.
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Some Medigap or Medicare Supplement policies also cover services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, here's what happens:
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Medicare will pay its share of the
for covered health care costs.
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Then, your Medigap policy pays its share.
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*Most people pay a monthly part B premium of $144.60. See part B page for more details. https://www.medicarestart.com/medicare-part-b
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Medicare Supplement policies, like most insurance, cover more of your portion of responsibility as you pay a higher monthly premium for coverage. Below is the standard supplement policy chart of available options. Different companies may offer these plans for different prices and have different rules and benefits beyond the standard chart benefits. For more specific assistance comparing costs, companies and benefits, contact a MedicareStart Insurance Agent today!
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* Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,300 before your Medigap plan pays anything.
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** After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.
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*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in inpatient admission.
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Starting January 1, 2020, Medigap plans sold to new people with Medicare won’t be allowed to cover the Part B deductible. Because of this, Plans C and F will no longer be available to people new to Medicare starting on January 1, 2020. If you already have either of these 2 plans (or the high deductible version of Plan F) or are covered by one of these plans before January 1, 2020, you’ll be able to keep your plan. If you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy one of these plans.