You probably have heard of the Medicare donut hole or maybe you have friends or family that have dealt with the Donut Hole. The Coverage Gap, also called the Donut Hole, has caused plenty of confusion for a lot of people. Hitting the gap ($3,820 in drug cost for 2019) and seeing an increase in the price of your medications is never enjoyable. When you reach the coverage gap the co-pays go away. However, in 2019 name brand drugs are discounted by about 75% and you’ll pay about 37% of the cost for generic medications. The gap changes every year and after you’ve spent the maximum allowed amount in the gap (total part D cost of $5,100 for 2019) you will reach catastrophic level coverage. Once in catastrophic coverage, you’ll only spend about 5% of the cost of your medications for the rest of the year. Only a small number of beneficiaries get to the catastrophic coverage stage every year.
A Medicare Advantage plan (or Part C) combines the benefits of Medicare Parts A and B, as well as, in some cases, prescription drug coverage provided by Part D. They may also provide some additional benefits like dental, vision and gym membership. Many plans do not have medical deductibles for in-network services and instead of co-insurance they may have co-pays (like $5 for an office visit) for many services. Medicare Advantage plans can on occasion be your very best bet since they might cost less and provide more coverage. In fact, many areas have Advantage plans that have no monthly cost to the Medicare beneficiary.
There are 11 distinct forms of Medicare Supplement plans and each is designated by means of a letter of the alphabet. So what is covered by each lettered plan is still the exact same no matter whom you buy your Medigap insurance from. Obviously, there are various Supplement plans, and that means you must obtain more than one Medicare Supplement quote to acquire the very best price possible. Because Medicare supplement plans are governed by the federal government, the advantages of a specific plan (like Plan C or Plan F) are precisely the same, whatever the insurance policy business you opt for. If you submit an application for a Medicare Supplement Plan after your Open Enrollment (Guaranteed Issue Right) there isn’t any guarantee an insurance policy business will sell you a policy in case you don’t meet the health underwriting requirements. It’s imperative that you get a program which can fit your budget without leaving you pinching pennies at the close of every month. Medigap plans are provided to supplement traditional Medicare, but they can be costly and many feel they cannot afford them. A Medigap plan covers just one person. All plans aren’t available in every state. Some plans also offer coverage for emergency travel insurance away from the USA.
A Medicare Supplement plan would typically do the job best for people that are unhealthy and who visit the physician frequently, live in a number of areas of the nation or wish to minimize unexpected medical bills. Finding the appropriate Medicare Supplement Plan might seem confusing in the beginning, but the more you research your alternatives and become acquainted with assorted plan-related provisions, the more you will have the ability to get the very best coverage for your requirements. The best thing about Medicare and Medicare Supplement is you don’t have to think about whether your doctor is in the network. The Issue-Age-Rated policy charges depending on the age you are when you get the supplement program.
Ready to talk about your options? I meet one on one with my Medicare customers to help them design a plan that does what you need it to do, pay your medical bills with no surprises. I want you to see your options in “black & white” so you truly understand the coverage and how to make Medicare work best for you. Set an appointment online or just call and text me with any questions at 317-296-8881. You can also leave me a message and I’ll make sure to get back to you ASAP.