Understand your Medicare Advantage coverage options.
Call for enrollment information.
8 a.m.-8 p.m., 7 days a week.
| COVERAGE | ORIGINAL MEDICARE (Parts A & B) | STAND-ALONE PRESCRIPTION DRUG PLAN (Part D) | MEDICARE ADVANTAGE PLAN (Part C) |
|---|---|---|---|
| $0 or low monthly plan premium | |||
| Doctor and hospital coverage |
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| Prescription drug coverage | |||
| Dental coverage |
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| Vision coverage |
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| Hearing coverage |
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Original Medicare: Parts A and B
Original Medicare is managed by the federal government and is just a starting point for your health care.
Part A covers in-patient medical hospital care, nursing facilities, hospice, and some home health care.
Part B helps cover doctor visits, outpatient care, and some preventive services.
- You usually pay a monthly premium and must meet yearly deductibles
- Covers 80% of the approved amount and you're responsible for the remaining 20%
- Most prescription drugs, hearing aids, and routine dental care are not covered
- No limit on yearly out-of-pocket costs
Medicare Advantage: Parts C
Medicare Advantage is offered by private insurers and combines the benefits of Parts A & B plus other potential benefits, like vision, dental, and hearing and much more.
- Maximum out-of pocket limit per plan year means 100% of allowed healthcare costs after you meet your out-of-pocket limit
- Helps you control and understand your financial risk
- Some plans include part D (prescription) coverage, fitness benefits, and FREE over-the-counter health care items
Common Types of Medicare Advantage Plans
Health Maintenance Organization (HMO)
- Usually requires you to get most care and services from in-network providers
- Costs are lower with in-network providers
- Must choose a Primary Care Provider (PCP)
- Need referrals to see a specialist
Preferred Provider Organization (PPO)
- Provide you with a preferred network
- Costs are lower with in-network providers
- Costs are generally higher with out-of-network providers
- Probably won't need a referral to see a specialist
Dual Eligible Special Needs Plans (D-SNP)
- Designed to coordinate covered benefits and services if you qualify for both Medicare and Medicaid
Medicare Advantage and Prescription Drug Coverage: Part D
If you rely on prescription drugs to maintain your health, you have several options for prescription drug coverage:
- Some Medicare Advantage (Part C) plans include prescription drug coverage (MAPD)
- If you have Original Medicare (Parts A & B), you can purchase a Prescription Drug Plan (PDP)
- Includes mail-order service to help you save money and time
- You may need to pay a deductible
- Discount programs and subsidies are available for those with qualifying income
Stages of Coverage
1. Deductible
The amount you pay before a plan covers your prescription drug costs, if applicable.
2. Initial Coverage
The plan pays its share of the cost, and you pay your share. This stage lasts until your payments and the plan’s payments total $2,000 for the year.
3. Catastrophic Coverage
Once your out-of-pocket costs for prescription drugs reach $2,000, you are no longer required to share costs beyond your plan co-pays for covered generic and brand name drugs.
Call us today to learn more & enroll.
8 a.m.-8 p.m., 7 days a week.
