Medicare has 3 basic options when it comes to plans: Medicare Supplements, Medicare Advantage Plans, and Medicare Savings Accounts (MSA).
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There are may Medicare Supplement plan but we focus on the most popular
Medicare Savings Account
This $0 premium plan has no networks or referral requirements, which allows you to choose your doctor, specialist or hospital while capping your yearly out of pocket expense for healthcare. In addition, you receive an annual deposit to use towards your medical expenses.
Medicare Advantage Plans replace your Original Medicare (A & B) with a network plan that is cost-effective but can limit patient choice and coverage.
ABC’s Of Medicare Plans
|Medicare Supplement||Medical Savings Account (MSA-MA)||Medicare Advantage
|Access To Any Doctor||Yes, if they accept Medicare, no referral necessary.||Yes, if they accept Medicare, no referral necessary.||Varies by plan, county or availability.|
|Access To Any Specialists||Yes, if they accept Medicare, no referral necessary.||Yes, if they accept Medicare, no referral necessary.||Varies by plan, county or availability.|
|Access To Any Hospitals||Yes, if they accept Medicare, no referral necessary.||Yes, if they accept Medicare, no referral necessary.||Varies by plan, county or availability.|
|Access To Exclusive Cancer Centers (MD Anderson)||Yes||Yes||Varies by plan, county or availability.|
|Includes RX Benefits||No; Freedom to choose PDP.||No; Freedom to choose PDP.||Varies by plan, county or availability.|
|Includes Dental||No; Dental is separate.||Deposit can be used for Dental.||Varies by plan, county or availability.|
|Monthly Premium + Part B||Approx. $100-300/mo + Part B||$0 + Part B||Varies by plan, county or availability.|
|Co-Pays||Possibly, depending on the plan.||None||Varies by plan, county or availability.|
|Deductibles||$0-200/yr. depending on the plan.||Depends on the plan, usually $3,000 - $5,000/yr.||Varies by plan, county or availability.|
|Max Out-of-Pocket (includes any co-pays, deductibles, out-of-pockets approved by Medicare or the MA company)||$0||Depends on the plan, usually $3,000 - $5,000/yr.||Varies by plan, county or availability.|
|Annual Deposits||$0||Approx. $2,000 - $3,000, depending on the plan.||$0|
|Health Questions||Yes; Usually underwritten if outside of an open/initial enrollment period.||No.||No.|
|Availability||Statewide||Statewide||Varies by plan, county or availability.|
|Highlights||Higher premium allows for access anywhere that Medicare is accepted and with that high premium there is very little out-of-pocket costs. If tyou can afford these, usualy the best option.||Flexibility of a Medicare Supplement with the low premium of a Medicare Advantage plan. This is a high-deductible plan and the annual deposit is used towards their deductible each year. Unused premium is rolled over indefinitely and can grow accordingly.||Varies by plan, county or availability.|
Medicare Supplement Plans
Original Medicare can be difficult to understand at best and choosing the right Medicare Supplement can be a daunting task! We are here to help. You may be asking yourself, “which Medicare Supplement insurance policy is right for me?” Well, It depends on what you are looking for. Some plans have no out-of-pocket expenses, while others have a only a deductible or even multiple deductibles and co-pays. In our experience, there are three plans that our clients usually choose from:
Popular Medicare Supplement Plans
No deductibles, no copays. This is a relatively expensive plan and, in our experience, has a high percentage of rate increases per year. This is typically a popular plan with people who don’t want to have a deductible or copay.
One annual deductible (mandated by Medicare & typically less than $200), with very small rate increases every year (usually half as much as a Plan F). This has become a very popular plan in the last few years and is great for people who want to save more money and still have great coverage.
One annual deductible (less than $200) with Dr. office copays (of less than $20) and ER copays (less than $50). This is a less expensive plan with typically fewer rate increases than Plan G and F. We recommend this plan for the savvy shopper who doesn’t visit the doctor very often.
The Difference in Companies
The cost of Medicare Supplement policies vary widely from company to company, and there can be huge differences in the premiums that different insurance companies charge for the exact same coverage. Every Medigap policy must follow Federal and State laws designed to protect you and the policy must be clearly identified as “Medicare Supplement Insurance.” Medigap insurance companies in most states can only sell you a “standardized” Medigap policy clearly identified with letters A through N. Each standardized Medigap policy must offer the same basic benefits, no matter which insurance company sells it. Cost is usually the only difference between Medigap policies.
Medicare Medical Savings Account (MSA)
A Medicare MSA or Medical Savings Account plan is a high deductible, $0 premium plan that actually pays you money towards your deductible each year. This plan allows you to pick any prescription drug plan. Similar to an HSA for under 65 individuals.
Medicare Advantage Plans
Medicare Advantage Plans
Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of your Part A and Part B benefits. Medicare Advantage Plans include:
Health Maintenance Organizations
Preferred Provider Organizations
Private Fee-for-Service Plans
Special Needs Plans
Medicare Medical Savings Account Plans
If you’re enrolled in a Medicare Advantage Plan:
Most Medicare services are covered through the plan
Medicare services aren’t paid for by Original Medicare
Most Medicare Advantage Plans offer prescription drug coverage.
We are happy to discuss Medicare Advantage plans with you if you’re interested.
Frequently Asked Questions
What Medicare Plans do you recommend?
Everyone’s situation is different, but generally speaking, we recommend Medicare Supplements or Medicare MSAs for our clients.
Does my supplement cover dental or prescription costs?
No. Your supplement does NOT cover dental or prescriptions, which is why we recommend dental plans for our clients, as well as a stand-alone Prescription Drug Plan.
Can I keep Original Medicare if I choose to take out a supplement?
Yes, your supplement is designed to work with Original Medicare.
Can I keep Original Medicare if I choose to take out a Medicare Advantage Plan?
No. When you enroll in Medicare Advantage, you automatically DISENROLL from Original Medicare and lose those benefits.
If I have coverage through a Medicare Supplement, why do I need a cancer plan?
The biggest expense most people have when going through cancer treatment is the cost of prescription medications. Most cancer medications are non-generic and can cost thousands of dollars out-of-pocket (even if you already have a Prescription Drug Plan). With cancer becoming so prevalent these days, we recommend ALL of our clients have a Cancer plan to help pay for expensive cancer medications, and even other expenses like travel to & from treatment locations. Click here to learn more about our cancer policy.
Is Long Term Care paid for by Original Medicare and/or my Medicare Supplement
Generally speaking, Medicare provides up to 20 days of skilled care, with a Medicare Supplement providing an additional 80 days, totaling up to 100 days of skilled care per year. Beyond that, an individual will be paying out-of-pocket, which is why we recommend Long Term Care or Home Health Care policies.
Who is the best Supplement company?
Every Medicare Supplement policy must follow federal and state laws designed to protect you, and they must be clearly identified as “Medicare Supplement Insurance.” All Supplement policies must offer the same basic benefits; a Plan G with Company A is going to be the exact same as a Plan G with Company B. Underwriting and price are really the only differences between the companies.
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