Medicare Supplements (Medigap), Medicare Advantage and Part D Plans
Medicare supplements, Medicare Advantage plans and Part D prescription drug plans are available for Medicare eligible individuals age 65 or older or individuals with other qualifications such as disability. Individuals will need both Medicare Part A and Part B to apply for supplements and Part D plans.
- Part A covers hospitalization and is free if you qualify.
- Part B covers primary care services and has a premium based on your last two years of salary.
- Medicare and supplemental coverage typically begin the first of the month in which an individual turns age 65, if in the initial enrollment period.
What do you do when you reach Medicare eligibility? Christy will help you navigate all the things to be considered!
With Medicare Supplements, insureds can see any provider accepting Medicare patients, nationwide. Coverage picks up where Medicare leaves off. Plan F is the most comprehensive Medicare plan and covers all Medicare approved expenses, as long as you see a Medicare approved provider. Plan F is no longer available to newly eligible Medicare enrollees effective January 1, 2020. Plan G is becoming the most popular Medicare Supplement with a very small out of pocket Part B deductible with huge premium savings compared to Plan F.
Medicare Advantage plans (Part C) take the place of original Medicare and are sold through private carriers, much like Medicare Supplement plans. These plans typically have a low to no premium; however, they have high out-of-pocket costs compared to Medicare Supplements. Medicare Advantage plans also use specific limited networks.
Part D prescription drug plans have specific networks and specific formularies, which vary by carrier and plan. Many carriers offer multiple plans to choose from with a variety of copays for tiered drugs.
In 2024, the Part D coverage gap (donut hole) starts when total annual drug costs reach $5,030 (paid by you and the plan). You then pay 25% coinsurance for formulary prescriptions until your out of pockets costs for the year reach $8,000. Catastrophic coverage begins once your total annual costs reach $8,000. During this phase you pay $0 for both brand and generic medications for the remainder of the year.
It is best to start preparing for your Medicare coverage at least three to four months prior to your 65th birthday.
MDIS does not offer every plan available in your area. Any information we provide is limited to those plans we offer in your area. Visit Medicare.gov or call 800-MEDICARE for information on all your options.