MEDICARE PART A
Hospital Expenses
MEDICARE PART B
Complete Medical Services
MEDICARE PART D
Prescription Drug Plans
Before you choose a plan, we want to make sure you understand the differences between your many options, particularly the differences between Medicare Supplements and Medicare Advantage Plans. Many people enroll in Advantage Plans believing they are Supplements, but they are not.
Medicare Choices
Medicare Supplement
Insurance Plans
A Medicare Supplement Insurance Plan is used in conjunction with traditional Medicare. Because they only need to bill Medicare, any carer who accepts Medicare will take a Supplement. Medicare pays its portion (generally 80% of Medicare-covered benefits) and forwards the balance to the Supplement, which pays its portion (generally 20%). It is important to note that Supplements DO NOT include Prescription Drug Coverage (Part D, PDP), and there will be a penalty if you do not get a PDP when you are first eligible. (There are some exceptions) The cost of a Medicare Supplement does not change yearly (although the price generally goes up, the coverage does not change).
Medicare
Advantage Plans
Medicare Advantage Plans, commonly known as “Part C” or “MA Plans,” are an “all-in-one” replacement for Original Medicare. They are provided by Medicare-approved private companies. You still have Medicare if you join a Medicare Advantage Plan. These “bundled” plans typically include Medicare Part A (Hospital Insurance) and Part B (Medical Insurance), as well as Medicare drug coverage (Part D).
Medicare Prescription
Drug Plans
(Part D)
These plans (also known as “PDPs”) supplement Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans with drug coverage. Each Medicare Prescription Drug Plan has a list of covered drugs (called a formulary). On their formularies, many Medicare drug plans categorize medicines into different “tiers.” The prices of drugs in each tier vary. A lower-tier drug will typically cost less than a higher-tier drug. In some cases, if your drug is on a higher tier and your prescriber believes you need that drug rather than a similar drug on a lower tier, you or your prescriber can request an exception from your plan to receive a lower copayment.