Frequently asked questions
Medicare Part C plans are also referred to as Medicare Advantage plans. These plans are offered by private insurance companies and allow you to get all the coverage Original Medicare (Part A and B) offers, plus additional benefits and services all in a single plan.
Many Medicare Advantage plans include prescription drug coverage (Part D), often for no additional premium.
Some plans also include extra benefits such as:
Routine vision, hearing and dental care
Wellness programs
Nurse phone line
Before you can enroll in a Medicare Advantage plan, you must sign up for Original Medicare (Parts A and B).
What is Medicare Advantage?
All Medicare supplement insurance basic benefits are standardized by the government and offered by private insurance companies. Medicare supplement plans are designed to help pay for some of the out-of-pocket costs Medicare doesn’t pay.
Some plans even cover deductibles. As a result, having Medicare supplement insurance could help you save on out-of -pocket medical expenses. Having a Medicare supplement plan also allows you to choose any doctor who accepts Medicare patients — and it travels with you nationwide.
Before you can enroll in a Medicare supplement plan, you must sign up for Original Medicare (Parts A and B).
What is Medicare Supplement Insurance?
NO. It doesn’t cost anything to have me help you select the right plan. The provider you select to provide your benefits will pay me for assisting you but you don’t pay a single penny of increased premium. You also get the added benefit of having a personal advisor to call when you need help. There is no obligation to enroll.
Does it cost anything to use your services?
In simplest terms a Medicare supplement is a pay now plan model and a Medicare Advantage plan is a pay later plan model. This is a question that really requires an appointment to evaluate your unique situation.
How do I decide between a Medicare supplement plan and a Medicare Advantage plan?
The Affordable Care Act is for those who are under 65 and not eligible for Medicare. Medicare is a separate program from the ACA and has its own rules and regulations.
How does the Affordable Care Act aka. Obamacare effect my Medicare coverage?
If you are on a group plan generally you won’t need to do anything until you retire. However you will want to check with your HR person for any specific requirement your specific group plan may have. If you are not on an employers group plan you will need to sign up for Medicare when you are first eligible. There are some exceptions to this rule and should be evaluated on an individual basis.
If I continue to work, do I need to sign up for Medicare?
No. You are only allowed to have one or the other. If you select a supplemental plan you will want to add on a prescription drug plan as well.
Can I have a Medicare Advantage plan and a Medicare Supplement plan?
If your Medicare Advantage Plan (Part C) includes prescription drug coverage and you join a Medicare Prescription Drug Plan (Part D), you’ll be dis-enrolled from your Medicare Advantage Plan and returned to Original Medicare.
In 2022, Congress passed the Inflation Reduction Act — a bill that contained among other things $500B in new spending and tax breaks. It is aimed to boost clean energy, reduce healthcare costs, and lower prescription drug costs for people with Medicare as well as aid in reducing federal drug spending.
The IRA has redesigned the Medicare Part D program to start January 1, 2025. Here are the highlights :
It eliminates the Coverage Gap or the donut hole,
It allows for reallocation of costs during the catastrophic phase,
It reduces the True Out of Pocket (TrOOP) to a maximum of $2000
TrOOP is a formula based on prescription drug manufacturer’s retail prices for plan-approved prescriptions. It is not based on your personal out-of-pocket costs.