Medicare Advantage Plans
(Part C)

These are plans that are directly contracted with CMS—the centers for Medicare and Medicaid (part C of Medicare).

When you enroll in a Medicare Advantage plan, CMS pays the plan—a private company—a fee to manage and administer your Medicare benefits.  You receive all the benefits of Original Medicare Parts A&B.  You also may receive extra benefits – such as dental, vision, hearing, gym memberships, etc.—depending on the plan you choose.  Your cost-share is in the form of low premiums, copays, and coinsurance as you use the services.

Many Medicare Advantage plans include Part D for prescription drugs.  Some plans offer low or zero premium options, and often have maximum out of pocket limits which serve as a “safety cap” for the member for Medicare covered services.

Medicare Supplement Plans

“Supplement” means “add.” A Medicare Supplement is added to or “supplements” your Original Medicare Coverage for Parts A&B. Original Medicare pays as your primary coverage and depending on the plan—you pay a monthly premium to the Medicare Supplement Insurance Company—and they pay all or part of approved charges that Original Medicare does not cover. Underwriting restrictions may apply, but there are Guaranteed Issue opportunities available at certain times for specific circumstances. These plans typically do not include Part D for prescription drugs, but you can obtain a stand-alone Part D Plan (PDP) to go with your Medicare Supplement Plan. You can also add stand-alone coverage for Dental and Hearing. Many Supplement Carriers offer preferred discounts on purchases like hearing aids, etc.

Hospital Indemnity Plans

Often the highest cost share line item in an Advantage Plan is the CoPay for Inpatient Hospital Stays. While Advantage Plans typically greatly reduce cost exposure by a known copay for a limited number of days, one can secure an extra layer of cost reduction through a Hospital Indemnity Plan which can be obtained to offset the entire cost or a portion of it. We will provide you with all the facts so you can determine if this could be a valuable part of your overall healthcare strategy.

Prescription Drug Plans (PDP) (Part D)

There are two basic ways to obtain PART D Prescription Drug Coverage - in a Medicare Advantage Plan which includes Part D, or as a stand-alone plan which can be combined with a PFFS, A Medicare Supplement, or with Original Medicare. While it is not possible to have both a stand-alone Part D Plan AND an Advantage Plan with Part D, our professional benefits advisors can help you discover which option is best based on your prescription list and your personal budget. Every Plan is different, every plan has a different formulary (Medicare approved Drug List). A common misconception is that if one chooses a low premium and low deductible, their drug costs will be lower. But, if drug copays are higher on a lower premium plan for a specific drug or group of drugs, one can end up with a higher overall yearly drug cost than perhaps a plan with a higher premium and lower copays. This is where our professional experts can provide a great service, helping you get the best possible scenario for YOUR unique needs. We can show you how to avoid Late Enrollment Penalties, and help you determine if you are eligible for Medicare Savings Programs. These plans change from year to year. We offer free lifetime consulting, monitoring those changes on your behalf. We work WITH you to stay informed and navigate the best options based on today’s needs, and make necessary adjustments based on changes you can’t possibly know about today.