Medicare Supplement (Medigap) Insurance
Sold by private companies, can help pay some of the health care costs that Original Medicare does not cover, like co-insurance, and deductibles.
These plans are standardized by Medicare and are named by letter. For example, a Plan G has the same coverage benefits from company to company. However, the cost or premium may vary from one company to another.
These plans cover in general only what Medicare covers. Some companies may include discounts for certain services such as for vision or a gym membership. They do not cover long term care, routine vision or dental, hearing aids, or private duty nursing.
Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company cannot cancel your Medigap policy as long as you pay the premium.
Medicare Advantage Plan (Part C)
A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans
You get all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D) usually at a much lower cost than a Medicare Supplement, and usually have a network of providers you must see except for emergency. If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan instead of Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage
Medicare Advantage Plans include a Maximum-out-of-pocket limit (MOOP) on what you pay in a year on Part A & Part B costs.
Many Advantage plans also include other benefits such as Dental, Vision, Hearing, Gym membershipm Over-the-counter benefits, transportation. Sometimes included or sometimes added on for an extra cost.
Each plan may have a different 'Formulary' or list of drugs they cover and can vary in cost and drugs covered and MOOP
Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules and guidelines set by Medicare and must cover all Medicare benefits.
***To have either a Medicare Supplement or a Medicare Advantage plan you must have Medicare Part A & Part B.
You must continue paying your Medicare premium along with the cost of your plan.
Medicare Prescription Plan
Medicare offers Prescription Drug Coverage (Part D) to everyone with Medicare. If you do not to join a Medicare Prescription Drug Plan first eligible, and you don't have other creditable prescription drug coverage, or you do not get Extra Help, or if you go more than 63 days without creditable drug coverage, you'll likely pay a late enrollment penalty when you do get a plan. To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare.
**HOW TO GET DRUG COVERAGE: You can get a stand alone prescription plan with your Medicare or along with a Medicare Supplement or you can get drug coverage through a Medicare Advantage plan which includes prescription coverage.
Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different "tiers", each tier having a different cost.
**You can't have prescription drug coverage through both a Medicare Advantage Plan and a Medicare Prescription Drug Plan except in LIMITED circumstances. If you're in a Medicare Advantage Plan that includes drug coverage and you join a Medicare Prescription Drug Plan, you'll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare!