Watch our VIDEO (below) on the PARTS & PLANS of Medicare

A hospital building with the word " hospital " on it.

Part A

In a word...HOSPITAL

Part A is the part of Medicare that covers inpatient care at a hospital. It also covers skilled nursing facility, and Hospice, and Home Health Care. (But not entirely)

A man in white shirt and tie with a doctor.

Part B

In a word... DOCTORS

Part B is (for the most part) outpatient care such as doctor office visits. It also includes outpatient tests (like x-ray, MRI and most bloodwork.

A person holding a pen and paper with a rx sign on it.

Part D

In a word.. DRUGS

Part D covers your prescription drugs (mostly). If you don't get it when you're first eligible you may face lifetime penalties. (Yes, there are exceptions)

What is Medicare Advantage (really)? You may have heard it's "Part C"

Part C (Medicare Advantage) is coverage from a private insurance company that is contracted by the government to manage your healthcare for one year. You can only enroll from Oct 15 to Dec 7 and your coverage starts the following January. There are special exceptions that may allow you to enroll other times. You no longer have Parts A & B and you can't enroll separately in Part D when you have Part C but most of these plans include prescription drug coverage. Medicare Advantage is sometimes called "pay as you go" because many have a $0 monthly cost but very high cost sharing when you receive care. Many Part C plans also require you to use network doctors and you can't use your Medicare card to go outside the network. Part C coverage must be equivalent to original Medicare but it doesn't have to be exactly the same. Many plans offer additional benefits such as Dental, Vision, Hearing, and other extra benefits. Some complaints about Part C are denial of treatment, prior authorization for care, and limited coverage for cancer treatments. Also, doctors and hospitals can leave your plan mid-year but you can't.

What's Medicare Supplement? It's also called "Medigap"

Medigap differs from Part C (Medicare Advantage) because you still have Original Medicare (Parts A & B) when you have a Medicare Supplement. In fact, you will use your Medicare card with PARTS A & B to pick up the difference (the gap) between what Medicare pays (usually 80%) and what it doesn't (the other 20%). You also the freedom to go to any US doctor who accepts Medicare, with no prior authorizations or referrals. Medigap plans have letter designations (e.g. F, G, N) and each lettered plan has the same exact benefits regardless of company. So, when comparing Medigap plans, you'll want to consider their loss ratios, size, stability, and history of rate increases (we have access to this data).

Four hands holding two white pieces of puzzle.

Watch this video BEFORE you enroll in Medicare Because it only takes one mistake to mess it all up!

Do you have 11 minutes? You won't want to miss this because it will save your time, your money, and your coverage! You don't want to mess up with Medicare. They're not very forgiving of mistakes.

Click HERE to learn what YOU need to know about YOUR Medicare There is NO obligation to enroll or change your current plan.

Do you have 11 minutes? You won't want to miss this because it will save your time, your money, and your coverage! You don't want to mess up with Medicare. They're not very forgiving of mistakes.

POPULAR MEDIGAP PLANS (MEDICARE SUPPLEMENT)

Plan F

  • In earlier years, Plan F was considered the "Cadillac" plan because it covered all of the deductibles and copays that Original Medicare does not cover. 
  • Plan F is usually the most expensive Medicare Supplement (Medigap) plan.
  • Today, Plan F is only offered to those individuals who turned 65 before 2020. 
  • Experts predict that as the population of seniors covered by Plan F declines (through death and attrition), the rates for these plans will continue to soar.  

Plan G

  • Plan G has the same coverage Plan F except Plan G does not cover the Part B deductible.
  • Plan G has a lower monthly premium than Plan F.
  • Plan G is also the plan that people can choose without answering health questions when they are eligible for guaranteed issue coverage. Guaranteed coverage means no health questions are asked on the application.  In other words, you can't be denied for health reasons. [For example: You are new to  Medicare (e.g. turn 65 and/or lose employer coverage or the Medicare Advantage plan (Part C) is no longer offered in your area.

Plan N

  • Plan N  has the same coverage as Plan G with two exceptions: 
  1. Copay: Plan N requires a copay up to $20 for some office visits and up to $50 for an emergency room visit (waived if you're admitted to the hospital). 
  2. Excess charges: In some states, doctors are allow to charge up to 15% more than what Medicare covers. These are called "excess charges." [For example, if the doctor charges $200 for an office visit but Medicare only allows $125, Medicare will pay the doctor $75. You will pay a $20 copay (which totals to 80%) and the doctor can charge you $18.75 more (15% over the Medicare allowable amount of $125). In this example, you would pay $38.75 for the office visit, UNLESS you live a State that don't allow excess charges]. See list below.
  • Plan N premium is usually lower than Plans F and G. When shopping rates between Plans G and N, factor in how often you go to the doctor. [For example: If you only see the doctor once or twice a year and Plan G is $100/month but Plan N is $80/month, you would save between $200-$220 per year on Plan N, even paying copays]. 

States in which excess charges are not allowed:

  • Connecticut
  • Massachusetts
  • Minnesota
  • New York
  • Ohio
  • Pennsylvania
  • Rhode Island
  • Vermont

FREQUENTLY ASKED QUESTIONS

Do you have a question that is not answered below?  Email rich@seniorscovred.com  if you cannot find an answer to your question and we may add it here!