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Medicare Compatible Plans

Medicare Supplement Plans (Medi-Gap)

Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as "Medicare Supplement Insurance." Insurance companies can sell you only a "standardized" policy identified in most states by letters.

All policies offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs. In MassachusettsMinnesota, and Wisconsin, Medigap policies are standardized in a different way.

Each insurance company decides which Medigap policies it wants to sell, although state laws might affect which ones they offer. Insurance companies that sell Medigap policies:

  • Don't have to offer every Medigap plan

  • Must offer Medigap Plan A if they offer any Medigap policy

  • Must also offer Plan G if they offer any plan

The chart below shows basic information about the different benefits Medigap policies cover.

  •        = the plan covers 100% of this benefit

  • No Check = the policy doesn't cover that benefit

  • % = the plan covers that percentage of this benefit

* Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,800 in 2024 before your Medigap plan pays anything.

** After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.

*** Plan N pays 100% of the Part B coinsurance, except for a co-payment of up to $20 for some office visits and up to a $50 co-payment for emergency room visits that don't result in inpatient admission

Excess charges- If you have Original Medicare, and the amount a doctor or other healthcare provider is legally permitted to charge is higher than the Medicare-approved amount, the difference is called the excess charge and is your responsibility, unless you select a plan that indicates "Yes", it does cover those charges.

Please note: effective 1/1/2020 Medicare Plan F's are no longer for sale for those turning 65 after 1/1/2020.

Medicare Prescription Drug Plan (PDP)

Medicare drug coverage helps pay for prescription drugs you need. It's optional and offered to everyone with Medicare. Even if you don’t take prescription drugs now, consider getting Medicare drug coverage. If you decide not to get it when you’re first eligible, and you don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get Extra Help, you’ll likely pay a late enrollment penalty if you join a plan later. Generally, you’ll pay this penalty for as long as you have Medicare drug coverage. To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage. Each plan can vary in cost and specific drugs covered. . 

Medicare Advantage Prescription Drug Plan (MAPD)

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. Medicare pays these companies to cover your Medicare benefits. If you join a Medicare Advantage Plan, the plan will provide all of your Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance) and Prescription Drug Coverage. This is different than a Medicare Supplement Insurance (Medigap) policy or a Prescription Drug Plan (PDP).

 

You get all of your Part A, Part B, and drug coverage, through these plans. Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.

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