Medicare Plan Options
For over 30 years, Neal Benefits has assisted clients with their Medicare choices. If you don't know where to start, simply give us a call to set up an appointment or to discuss over the phone. We make the Medicare transition as simple as possible, but we also know how important it is to be educated and informed. We want you to know your options, then help direct you to the plan that best fits your needs. We charge no fee's for our services so you have nothing to lose, but much to gain.
Types of Plans:
Medicare Supplemental (Medigap)
A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will pay both their shares of covered health care costs.Insurance companies can only sell you a “standardized” Medigap policy. These Medigap policies must all have specific benefits so you can compare them easily.You may be able to choose up to 10 different standardized Medigap policies (Medigap Plans A through N). Medigap policies must follow Federal and State laws. These laws protect you. A Medigap policy must be clearly identified on the cover as “Medicare Supplement Insurance.” Each plan, A through N, has a different set of basic and extra benefits.It’s important to compare Medigap policies because costs can vary. The benefits in any Medigap Plan A through N are the same for any insurance company. Each insurance company decides which Medigap policies it wants to sell.Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium. In addition, you will have to pay a premium to the Medigap insurance company.You and your spouse must each buy separate Medigap policies. Your Medigap policy won’t cover any health care costs for your spouse.
Medicare Advantage Plan (MA)
A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non‑emergency or non-urgent care). These rules can change each year.Different Types of Medicare Advantage Plans
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Health Maintenance Organization (HMO) Plans
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Preferred Provider Organization (PPO) Plans
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Private Fee-for-Service (PFFS) Plans
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Special Needs Plans (SNP)
There are other less common types of Medicare Advantage Plans that may be available:
HMO Point of Service (HMOPOS) Plans— An HMO plan that may allow you to get some services out-of-
network for a higher cost.
Medical Savings Account (MSA) Plans - A plan that combines a high deductible health plan with a bank
account. Medicare deposits money into the account (usually less than the deductible). You can use the
money to pay for your health care services during the year.
Medicare Prescription Drug Plan (PDP)
Medicare Prescription Drug Plans add coverage to the Original Medicare Plan, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare.When you join a Medicare Prescription Drug Plan, you use the plan member card that you get from the plan when you go to the pharmacy. When you use the card, you will get a discount on your prescriptions.Your costs will vary depending on your financial situation and which Medicare Prescription Drug Plan you choose. If you have limited income and resources, you may get extra help to cover prescription drugs for little or no cost.
