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Explore Medicare plans with SelectQuote.

Let us help you make sure you’re receiving all the benefits you deserve. There’s no obligation to enroll.

Explore Medicare plans with SelectQuote.

Let us help you make sure you’re receiving all the benefits you deserve. There’s no obligation to enroll.

Understanding Medicare Plans

For people age 65 and or older, as well as those with certain disabilities under the age of 65, there are many different Medicare coverage options to fill gaps in Original Medicare or get extra benefits. When deciding what type of plan you need, it’s helpful to understand what’s included with each plan and to compare costs. It’s also important to consider whether or not your current physician(s) can accept your plan and coverage for prescription drugs you may need to take.

Medicare Advantage Plan

Medicare Advantage plans—also referred to as Part C—cover Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). These plans are offered by private health insurance companies that are approved by Medicare, and in addition to covering hospital and medical insurance, many Medicare Advantage plans also include prescription drug coverage. Some Medicare Advantage plans also include additional benefits, such as routine dental, vision, hearing and fitness.

If you decide to purchase a Medicare Advantage plan, you may have to pay a monthly premium, but some plans can be as low as $0 a month. Some plans require a deductible while others do not—copayments and coinsurance can vary greatly with Medicare Advantage plans. For example, one plan may charge you a 20% coinsurance to see a primary care doctor and another may charge you $0. When considering a Medicare Advantage plan, it’s important to consider all of the available plans in your area to ensure you get the right plan for your needs. Let us help—there’s no obligation to enroll.

Medicare Supplement Insurance Plan

Medicare Supplement Insurance plans, also commonly referred to as Medigap, help to provide for gaps in coverage from Medicare Parts A and B including:

  • Copayments
  • Coinsurance
  • Deductibles
  • Copayments
  • Coinsurance
  • Deductibles

In most states, there are a total of 10 Medicare Supplement insurance plans to choose from and all policies have been standardized by the government. Note that standard Medigap policies are different in Massachusetts, Minnesota and Wisconsin.

All Medicare Supplement Insurance plans generally cover Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted. Additionally, they generally cover:

  • At least 50% of Medicare Part B coinsurance or copayment
  • The first three pints of blood received in a medical procedure
  • Part A hospice care coinsurance or copayment
  • At least 50% of Medicare Part B coinsurance or copayment
  • The first three pints of blood received in a medical procedure
  • Part A hospice care coinsurance or copayment

Your Medicare Supplement Insurance plan may or may not cover all or part of:

  • The skilled nursing facility care coinsurance
  • Medicare Part A deductible
  • Medicare Part B deductible
  • Medicare Part B excess charges
  • Foreign travel emergencies up to plan limits
  • The skilled nursing facility care coinsurance
  • Medicare Part A deductible
  • Medicare Part B deductible
  • Medicare Part B excess charges
  • Foreign travel emergencies up to plan limits

Prescription drugs are not covered by a Medicare Supplement plan but you can purchase a stand-alone Part D plan for your prescription drug needs.

In terms of cost for Medicare Supplement insurance plans, most have a monthly premium that’s set by the private insurance companies who offer these plans. The premiums are based on age, health status, gender and various other factors and you’re expected to pay the premium even if you do not use any medical services. Only Medicare Supplement Plan K and Plan L have an out-of-pocket maximum.

Lucky for you, we can help you do that. We can help you navigate the complexities of Medicare and provide a better understanding of each plan option, answering any questions you have along the way. The service is free and there’s no obligation to enroll.

Medicare Prescription Drug Plan

Prescription drugs you take at home are not typically covered by Original Medicare. You have two options for prescription drug coverage through a Medicare plan:

  • Enroll in a stand-alone Part D Prescription Drug plan that works alongside Original Medicare
  • Choose a Medicare Advantage plan that also includes prescription drug coverage
  • Enroll in a stand-alone Part D Prescription Drug plan that works alongside Original Medicare
  • Choose a Medicare Advantage plan that also includes prescription drug coverage

Medicare drug plans have a list—also referred to as a formulary—of covered prescription drugs. Plans may include both brand name and generic prescription drugs. Medicare drug plans generally need to include at least 2 drugs in the most commonly prescribed categories and classes, but plans can choose which drugs are covered and which ones aren’t.

If you are already taking prescription drugs, be sure to check that your prescription is covered before you sign up for a plan. If changes do take place during the year involving a drug you’re taking, your plan must:

  • Give you written notice at least 30 days before the change becomes effective.
  • At the time you request a refill, provide written notice of the change and at least a month’s supply under the same plan rules as before the change.
  • Give you written notice at least 30 days before the change becomes effective.
  • At the time you request a refill, provide written notice of the change and at least a month’s supply under the same plan rules as before the change.

Generally, using drugs on your plan’s formulary will save you money. If you use a drug that isn’t on your plan’s drug list, you’ll have to pay full price instead of a copayment or coinsurance, unless you qualify for a formulary exception.

In terms of monthly costs, most Medicare Prescription Drug plans charge a monthly premium. You will need to pay this in addition to the Medicare Part B premium. If you join a Medicare Advantage plan (Part C) that includes Medicare prescription drug coverage, the plan’s monthly premium may include an amount for drug coverage.

Deductibles vary between Medicare drug plans. A deductible is the amount you pay out of pocket before your plan begins. Medicare drug plans cannot have a deductible more than $435 in 2020 and some Medicare drug plans may have a $0 in-network deductible.

Last, Medicare prescription drug plans may also have a copayment or coinsurance.

  • With a copayment, you pay a set amount (say, $10) for all drugs on a tier. Each plan can divide its tiers in different ways and each tier costs a different amount. Generally, a drug in a lower tier will cost you less than a drug in a higher tier.
  • With coinsurance, you pay a percentage of the cost (say, 25%) of the drug.
  • With a copayment, you pay a set amount (say, $10) for all drugs on a tier. Each plan can divide its tiers in different ways and each tier costs a different amount. Generally, a drug in a lower tier will cost you less than a drug in a higher tier.
  • With coinsurance, you pay a percentage of the cost (say, 25%) of the drug.

Explore Your Medicare Options

In just minutes, we can compare Medicare options available in your area. Some plans have premiums as low as $0/month and may also include dental, vision and prescription drug coverage. Don’t wait to ensure you’re getting all the benefits you deserve. Get started today—there’s no obligation to enroll.

We do the shopping. You do the saving.