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MEDICARE ADVANTAGE PLANS (Part C)

MEDICARE ADVANTAGE PLANS (Part C)

Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage.  Medicare Advantage Plans are offered by Medicare-approved private companies that must follow rules set by Medicare.  Most Medicare Advantage Plans include Prescription Drug coverage (Part D).  In many cases, you'll need to use health care providers who participate in the plan's network and service area for the lowest costs.  These plans set a limit on what you'll have to pay out-of-pocket each year for covered services to help protect you from unexpected costs.  Some plans even have zero monthly premiums.

MEDICARE SUPPLEMENT PLANS (Medi-gap)

Medigap is Medicare Supplement Insurance that helps fill the "gaps" in Original Medicare and is sold by private companies and offered by Powers Financial and Insurance Group.  Original Medicare pays for much, but not all of the cost for covered health care services and supplies.  A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like:      

       -Copayments

       -Coinsurance

       -Deductibles

Some Medigap policies also cover services that Original Medicare doesn't cover, like medical care when you travel outside the U.S.  if you have Original Medicare and you buy a Medigap policy, here's what happens:

        -Medicare will pay it's share of the Medicare approved amount for covered health care costs.

        -Then, your Medigap Policy pays it's share. 

6 things to know about Medigap policies

        1.  You must have Medicare Part A and Part B

        2.  A Medigap policy is different from a Medicare Advantage Plan.  Medicare Advantage Plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare Benefits.

      3.  You pay the private insurance company a monthly premium for your Medigap policy.  You pay this monthly premium in addition to the monthly Part B premium that you pay Medicare.

      4.  A Medigap policy only covers one person.  If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.

      5.  You can buy a Medigap policy from any insurance company or agent that is licensed in your state to sell Medigap Policies.

      6.  Any standardized Medigap policy is guaranteed renewable, even if you have health problems.  This means the insurance company can't cancel your Medigap policy, as long as you pay the premiums.

PRESRIPTION DRUG PLANS (Part D)

PRESRIPTION DRUG PLANS (Part D)

Original Medicare (Part A and Part B) does not cover prescription drugs, so you will need to enroll in a Stand Alone Prescription Drug Plan.  Or, enroll in a Medicare Advantage Plan (Part C), that includes Prescription Drug Coverage.  The cost that a member pays fluctuates throughout the year.  Below are the 4 stages for 2024, and are the same for PDP and MAPD.

Stage1: Deductible Stage

Member pays 100% of drug costs (if applicable), until they reach their annual deductible.

Maximum deductible for 2024 is $545.00.

Stage 2: Initial Coverage Stage

Member pays a percentage of the plan's cost for covered drugs.  Once you and your plan spend $5,030.00 combined on drugs (including deductible), you're in the coverage gap.

Stage 3: Medicare Part D Coverage Gap

Member pays no more than 25% of the cost for brand-name and generic drugs until out-of-pocket total reaches $8,000.00.

Stage 4: Catastrophic Coverage

Starting in 2024, members will pay $0 for covered Part D drugs during the Catastrophic Phase. 

Do you need help enrolling, want a free quote, or have a question?

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We do not offer every plan in your area. Currently, we represent 15 organizations which offer 300 products.  Please contact Medicare.GOV, 1-800-MEDICARE, or your local State Health Insurance
Program (SHIP) to get information on all of your options.
By submitting this form, you agree that a licensed sales representative may contact you about Medicare Advantage, Prescription Drug, and Medicare Supplement Insurance plans.