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Basic Medicare is the federal health insurance program for people aged 65 or older, people under 65 who have had disability coverage for 2 or more years and people with End-Stage Renal disease (ESRD). Basic Medicare generally pays 80% of your costs and does not have maximum out of pocket protection.

Basic Medicare consists of two parts, A and B. Part A is usually at no cost if you have worked and paid payroll taxes. Part B has a premium that is set each year on a federal level. Part A and B cover:

You also need to buy a Part D plan from private carriers to cover your prescriptions. If you do not have a Part D plan, you may be subject to penalties. There are exceptions to this, for example, if you are a veteran.

This is a very quick explanation. If you want more information, please contact me and I’ll be glad to answer any of your questions!

What are Medicare Advantage and Medicare Supplemental (Medigap) Plans?

This can be very confusing, but here is a quick overview of the differences. Most people add one of these plans to their basic Medicare coverage for more protection, more benefits and lower costs.

Medicare Supplemental (Medigap) Plans

These are plans that work with Medicare to pay most of what basic Medicare does not. The benefits are set on a federal level and are identified by different plans lettered A-N. This can be confusing as other parts of Medicare use letters as well – for example, Medicare parts A, B, C or D! The basic coverage for a Supplemental plan is the same across all insurance carriers. The differences are the price and any additional benefits or discount programs they offer. Supplemental plans require you also get a Part D prescription coverage plan.

Medicare Advantage Plans

You may have seen these plans advertised on TV. They are and all-in-one option for your Medicare needs. Many plans have comprehensive coverage, including prescription coverage. These plans can have monthly premiums of $0 dollars and some even “giveback” some of your Part B premium. The tradeoff is they may have deductibles, copays and coinsurance when you use the services. They may have additional benefits for things like dental and vision, and even alternative services like naturopathy, acupuncture, massage and fitness access like SilverSneakers.

There is no one plan that fits everybody. I specialize in Medicare and I am happy to answer your questions and help you decide what is right for you. If you want more information, please contact me and remember my services are at no cost to you!

Here is a summary of the plan differences: