The questions surrounding Medicare are complex, and the solutions don’t seem clear.   It is easy to get lost in the information-overload regarding plans, benefits, enrollment periods and options available to you.  It’s hard to know what questions to ask, let alone how to sort out answers.  Our goal is to help you make sense of the giant Medicare puzzle, and find the pieces that fit you.

Below, you’ll see some general features of each type:

Medicare Advantage (also known as Part C, or MAPD) 

  • Administered by private insurance companies 
  • By law, must provide at least the same coverage as Original Medicare (Parts A & B) 
  • Plans have their own schedule of fees, such as copays, coinsurance and deductibles​

                     You will still pay your Part B premium, but some plans offer a “giveback”, a type of reimbursement

  • Most popular are HMOs, PPOs, PFFS (Private Fee-For-Service) plans, SNPs (Special Needs Plans) and Medicare Medical Savings Accounts
              ​You may be restricted to networks, or pay more for out-of-network care

  • Many include Part D, or prescription drug coverage (these plans are called MAPD plans)
  • Usually include additional (limited) benefits such as:

                     Vision

                     Dental

                     Hearing

                     Fitness club/gym memberships

                     Over-the-counter allowances (shower benches, rubbing alcohol, etc.)

  • Provide a maximum out-of-pocket expense for the calendar year to protect your finances
  • Plan can change or be eliminated year to year; doctors are not guaranteed to remain in-network


Medicare Supplement plans (Medigap) 

  • Works in addition to, or supplements, Original Medicare
  • Designed to pay much of the deductibles, copays and coinsurance Parts A & B leave to you.  Unlike Medicare Advantage plans, they do not provide Medicare coverage Supplement plan coverage is standardized across insurance companies in the forms of plans A through N
  • Supplements have monthly premiums; although plans are standardized, premiums vary between insurance companies
  • No networks to be concerned about; Medicare pays its share of cost, then your supplement plan pays its share
  • Plans are guaranteed-renewable; you cannot be dropped due to your health as long as you pay your supplement premiums
  • Supplement plans do not include Part D prescription drug coverage, and you will continue to pay your Part B premium
  • You cannot have a Medicare Advantage plan and a supplement plan at the same time


 You do not have to choose a Medicare Advantage plan or a supplement plan; you may simply enroll in Original Medicare; however, these two approaches to Medicare insurance can provide additional help.  Since your healthcare is a personal matter, it is important to know which approach is most beneficial to you and your individual needs.  1st Advantage Insurance has been in the business of helping people find what they need for over 10 years.  We can provide you with the advantage of professional assistance, with no obligation.  If you would like to speak about your options, contact us at (727) 535-0189 today. 

Call now  727-535-0189
 
Toll free  866-572-0189
Fax 727-824-7976

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