Medigap Plans, Medicare Advantage, and Part D

*This is Part 3 in a 3-part series designed for people going on Medicare or turning 65. Please
medigapcontact us if you have any questions about this information or fill out a quotes request if you want to get Medigap quotes.*

Medigap plans, Medicare Advantage and Part D are additional coverages that you should be considering if you are going on Medicare. Each of these has their own unique designs and advantages/disadvantages. This article is intended to introduce you to each and give you more information to consider about what is right for you.

First of all, let’s take a look at Medigap plans. Medigap plans are sold through private insurance companies, but they are Federally-standardized. What this means is that each company has to offer one of the standardized plan designs. The chart that shows these standardized plans can be seen here. As you can see, Plan F is the most comprehensive plan – it pays what Medicare Parts A & B do not cover at the doctor and hospital, so you should not have any out of pocket expenses. It is, of course, the most expensive. Other common lower-premium, less-coverage options include Plan G and Plan N. Plan G, in particular, is often a better value than Plan F (Read more about Why Plan G is often better than Plan F).

In addition to the coverage being standardized with Medigap plans, the claim payments and doctor acceptance are also standardized. That is, if a doctor/hospital takes Medicare, he or she will take the standardized Medigap plan that you have, regardless of which company sells you the plan. Additionally, claim payments are processed through the Medicare “crossover” system, so the plans, essentially, “follow” Medicare as a supplement and claims are all handled electronically. For these reasons, it is important to compare the Medigap plans on the basis primarily of cost and company rating. These are the two variables that can differ from one company to the next. You can get a Medigap quotes comparison for you area sent to you by email.

Medicare Advantage is entirely different from Medigap. Many people mistakenly lump them in together or call Medicare Advantage plans “Medicare Supplements”. This is not accurate, as Medicare Advantage plans do not supplement Medicare, but rather take its place in paying claims. These plans have networks, and most are either PPOs or HMOs. Often, premiums are lower than the premiums of Medigap plans, but the coverage is typically also lower. They, in most cases, work more like traditional employer/group type plans. There are some distinct drawbacks to this type of plan, in our experience, and we do not recommend them in most instances. Some of the particular downsides are the network restrictions (which are often based on your county or state) and future plan change issues. If you take a Medicare Advantage plan when first eligible for Medicare, you do have to qualify medically to switch to a Medigap plan at a later time.

Medicare Part D is a part of Medicare, but it is sold through private insurance companies. Part D covers prescription drugs. There are typically 20-40 plans in each county, so it is crucial to compare the plans based on how well they cover your current medications. Co-pays and plan premiums can vary greatly. You can do this on Medicare’s website at: Compare Part D plans.

It is important to sign up for Part D when first eligible unless you have creditable coverage. Medicare imposes a 1% per month penalty if you do not sign up for a Part D plan when you are first eligible (you are exempt from this penalty if you have creditable coverage through an employer-type plan). Premiums for Part D typically range from $15/month to $100/month so it is vital to choose a plan that covers your medications and is the appropriate coverage level for your current medication usage. You can change Part D plans during the annual enrollment period which runs October 15-December 7 each year.

This article explains some of the other coverages that go with Medicare, such as Medigap, Medicare Advantage and Part D. If you still have questions or want to discuss further, please feel free to contact us.

Medigap-Quote.com is one of the nation’s leading independent brokers of Medigap plans. We work with 30+ companies in 40+ states and work exclusively with this type of insurance. As a result, we can provide unbiased, experienced expertise to those going on Medicare and turning 65. Feel free to contact us or request Medigap quotes online.

Medigap Questions – Am I Covered If I Live Half the Year in Another Place?

Medigap plans can be confusing to many people. Although the coverage of the plans is completely Federally-standardized, there are still many questions that people on Medicare ask about the plans and how they work. One of those such questions concerns traveling with your Medigap plan and if, when you travel, your coverage goes with you.

First and foremost, it is important to understand that Medigap plans can be used anywhere nationwide that takes Medicare. Medicare, as you know, is a national program. Any doctor/hospital that accepts Medicare patients is required to accept the Medigap plans. So, in short, the answer is yes. If you travel to another state, or live in another of the country for half of the year or a few months out of the year, you are covered there just as if you were in your primary residence. Coverage is the same nationwide.

There are some other implications around this that you should be aware of. First of all, note that Medigap plans have nationwide coverage that is the same with all companies and accepted anywhere that takes Medicare. However, Medicare Advantage plans – the other type of plan that you can get if you are on Medicare – do not work the same way. These plans have specific networks that you must stay within and they are specific to a certain county, region or geographic area.

Another implication that is somewhat related as it pertains to travel and Medigap plans is international travel. As you will notice on the plan coverage chart, many of the Medigap plans – most, in fact – do cover “Foreign Travel Emergency”. This benefit is part of Medigap plans (not covered under “traditional” Medicare). It is up to $50,000 lifetime maximum benefit that can be used if you traveling abroad. The primary Medigap plans, such as Plan F and Plan G do include this benefit.

There are many questions associated with Medicare and Medigap insurance. At Medigap-Quote.com, we strive to answer your questions quickly and completely. If you have questions, you can reach us at 877.506.3378 or contact us online at: Medigap-Quote.com.

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