To better assist; the options below are linked to different Medicare & Medicaid Plans.
Take a minute to review to be better informed as to the coverage you would feel necessary and comfortable with.
Medicaid (medicaid.gov)
Medicaid provides health coverage to 7.2 million low-income seniors who are also enrolled in Medicare. Medicaid also
provides coverage to 4.8 million people with disabilities who are enrolled in Medicare. In total, 12 million people are
"dually eligible" and enrolled in both Medicaid and Medicare, composing more than 15% of all Medicaid enrollees.
Individuals who are enrolled in both Medicaid and Medicare, by federal statute, can be covered for both optional and
mandatory categories.
Dual Eligible Plans Medicare Advantage plans offer Medicaid options for the financially less fortunate as well as
Veterans. It can benefit the subscriber with a local doctor at no expense as well as other Medicare Advantage benefits
(listed below). Prescriptions are not covered under a Dual Eligible Plan they are covered under Medicaid or VA. It was
designed to assist in improving medical care for the subscriber at no cost.
Medigap - Medicare Supplement Insurance, is a type of health insurance that offers additional coverage for normal
Medicare plans. It helps fill in the “gaps” in Medicare coverage by helping you pay for out-of-pocket costs that Medicare
won’t cover. Some of these expenses include:
Deductibles
Copayments
Coinsurance
Health care costs when you travel internationally
Medicare Advantage
Medicare Advantage, also called “Plan C,” offers an alternative to the original Medicare plans. Medicare "Plan C" plans
are bundled with the typical Medicare Plan A and Plan B, creating more complete coverage for the insured person.
If you opt for Medicare Advantage, you are still a Medicare patient. Medicare Advantage plans are typically provided by
private insurance companies that are approved by Medicare, but they are funded by the government and maintain
standard Medicare coverages. In addition to normal Medicare coverage, most Medicare Advantage plan covers expenses
for:
Wellness Programs (health care - gym memberships)
Prescriptions (restrictions)
Vision
Dental
Hearing
While the exact details vary depending on the specific plan, Medicare Advantage plans can also be tailored to cover costs
related to chronic illnesses or conditions that you may have. The Medicare Advantage plans may also cover additional
expenses, such as:
- Transportation to doctor’s visits
- Over-the-counter medications
- Adult daycare services
Many Medicare Advantage Plans also include Medicare Part D, also known as prescription drug coverage. However, if the
plan doesn’t include this, you can always join a separate Medicare prescription drug plan.
Is it better to have Medicare Advantage or Medigap - Medicare Supplement Insurance?
Key Differences:
Price
Generally speaking, Medigap - Medicare Supplement Insurance plans have higher premiums than Medicare Advantage
plans. Medicare Advantage plans may cover less expenses resulting in more out of pocket expenses than Medigap -
Medicare Supplement Insurance. You can save money by choosing the plan that makes sense for your specific
medical/health conditions and lifestyle.
Choice of Doctors
One key difference that might influence your decision to select a Medigap - Medicare Advantage Insurance plan is the
choice of physicians. Be mindful of the limitations of both plans if you have a chronic condition that requires you to see
a specific specialist. Medicare Advantage offers a select approved selection of physicians and facilities within their
network. Some Medicare Advantage plans don’t cover out-of-network physicians or charge additional fees. In general
Medigap - Medicare Supplement Insurance plans offer more flexibility. Medigap - Medicare Supplement Insurance plans
are honored by medical facilities that accept Medicare throughout the USA.
Location
One major restriction regarding the plan you choose is where you are located and your lifestyle. If you live in one state
and rarely travel, then Medicare Advantage might be suited to you. If you live in more than one state throughout the
year or travel frequently, then a Medigap - Medicare Supplement Insurance plan may be a good choice. Medicare
Advantageplans usually offer coverage in one location/state or region exclusively. They also don’t typically offer
coverage whentraveling internationally. In contrast, many Medigap - Medicare Supplement plans plans provide coverage
in all 50 states and when traveling outside of the U.S.
Benefits of Medigap - Medicare Supplement Insurance Plans
Medigap - Medicare Supplement Insurance plans improve on Medicare plans A and B by filling in the Gaps in coverages
and provide a more comprehensive scope of coverages for the insured. Several plans can cover out of pocket costs in
the original Medicare plans.When filing a claim there is less effort with Medigap - Medicare Supplement plans. in many
cases no paperwork payment to providers are paid automatically after Medicare pays its portion of the expense.
Benefits of Medicare Advantage Plans
Medicare Advantage is an extension of Medicare plans A and B, offering more coverage than Original Medicare. This
option is very popular because of the low cost, it replaces the Original Medicare Plan while remaining affordable. It
has much lower premiums if you don’t use it frequently. For many plans, if you hit the maximum out-of-pocket costs
(+/-$5,500), the plan will cover you for the rest of the year.
Most Medicare Advantage plans include prescription drug coverage or Plan D. Medigap does not offer prescription
drug coverage, it has to be added separately. many Advantage plans also include gym memberships and
transportation.
Due to Governmental regulations and different Medigap - Medicare Supplement & Advantage plans
we are unable to advise until we are aware of your needs and have your permission.