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 three 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.
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, so there are no out-of-pocket expenses except the premium. 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 carriers, much like Medicare Supplement plans. These plans typically have a low 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. Many carriers offer multiple plans to choose from with a variety of copays for tiered drugs. In 2021, the Part D coverage gap (donut hole) starts when total annual drug costs reach $4,130 (paid by you and the plan). Catastrophic coverage starts when total annual drug costs reach $6,550 (paid by you and the plan). Once out of the donut hole, catastrophic coverage begins, at which time the out of pocket expense for drugs decreases to around 5 percent of cost.
It is best to start preparing for your Medicare coverage at least three to four months prior to your 65th birthday.
For more information regarding this coverage, email
or call 800-944-7550.