Is a Medicare Supplement (Medi-Gap) Plan Right For You? | How to Insurance | 050

Hi, I’m Peter!

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Helping YOU understand insurance, 

building CONFIDENCE for your future! 

Employer Healthcare

Original Medicare

Medicare Advantage

Medicare Supplements

Medigap

Part D Rx Plans

With so many options, it can be difficult to decide what’s best for you. 

However, if you’re 65 years or older, you have some fantastic benefits available to you, including the option of a “Medi-Gap” or Medicare Supplement.

Is a Medicare Supplement (Medi-Gap) Plan Right For You? 

As a refresher, there are several parts to Medicare: 

• Medicare Part A - Hospital Insurance 

• Medicare Part B - Medical Insurance 

• Medicare Part C - Medicare Advantage Plans (including Part D)

• Medicare Part D - Prescription Drugs

• Medicare Supplements (aka “Medi-Gap”)

First, you need to be enrolled in Medicare Part A and B by logging into MyMedicare.Gov or by enrolling in Social Security. 

Second, you need to decide if you want to use an additional plan to help you pay for most or all of your medical costs both now and in the future. 

Your main options are:

1. Medicare Advantage (MAPDs are more similar to a HMO health plan)

2. Medicare Supplement (“Medi-Gap” is more similar to a PPO health plan)

The medicare.gov

booklet “Medicare and You” provides an excellent description:

How does Medigap work?

Original Medicare pays for much, but not all, of the cost for covered health

care services and supplies. Medicare Supplement Insurance (Medigap)

policies sold by private companies can help pay some of the remaining

health care costs for covered services and supplies, like copayments,

coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original

Medicare doesn’t cover, like medical care when you travel outside the U.S.

Generally, Medigap doesn’t cover long-term care (like care in a nursing

home), vision or dental care, hearing aids, eyeglasses, or private-duty

Nursing.

Medigap plans are standardized

Medigap must follow federal and state laws designed to protect you,

and they must be clearly identified as “Medicare Supplement Insurance.”

Insurance companies can sell you only a “standardized” plan, identified in

most states as plans A – D, F, G, and K – N. All plans offer the same basic

benefits, but some offer additional benefits so you can choose which one

meets your needs.

Medicare is highly regulated and there are many rules, laws, and facets to each part...  which is why Medicare can be so confusing. 

So, as your insurance broker, I’m going to try to make it simple with some broad generalizations below: 

Medicare Supplement (“Medi-Gap”) Basics: 

1. Without an MAPD or Supplement, your original Medicare only covers 80% of your healthcare expenses and does NOT have an out-of-pocket maximum limit… so you’re vulnerable to huge medical bills. 

2. Medicare Supplements work more like a PPO healthcare plan, allowing you to manage your own care, choose your doctors/specialists and access care without the need of a network. 

3. Some Medicare Supplements do NOT have any additional co-pays or out-of-pocket-maximums (e.g. Plan G only has a $198 annual deductible).

4. You pay one set monthly premium...and then no other (or few) additional costs.

5. You can have a more predictable monthly budget for healthcare (instead of dreading additional costs if you go to the hospital or have surgery).

6. Prescription Drug Plans are not included, so you will want to add an additional plan to cover your prescriptions. (Not having a Part D plan can result in a future penalty of 1% per month additional charge for the rest of your life.)

7. Medical care and access to doctors can be nationwide, which is good if you like to travel the USA. (International medical costs are covered up to $50,000).

8. Telemedicine, phone, and online doctor appointments are available. 

9. Medicare Supplements generally do NOT offer the other benefits that Medicare Advantage plans might, such as dental, vision, hearing, and fitness memberships (but every plan is different and may have extra features).

The list can go on and on. 

Every plan is different and the best way to figure out the differences is to ask your independent insurance broker.

Here is a chart from Medicare.gov showing the different Medigap Plans

In general, I find many clients like a Medicare Supplement Plan because of:

• A predictable way to budget your monthly costs

• Access to a huge selection of doctors and specialists

• Ability to travel the 50 states and access care wherever they go. 

Next Steps: 

1. Talk to your trusted independent insurance broker about what plan may fit your needs best. 

2. Look at all the plans available to you

3. Select a Medicare Supplement and Prescription Drug Plan that provides what you need at the LOWEST possible annual cost.

At Apple Insurance Solutions,

We all want to protect what matters most to us in life, 

but finding the right insurance can be confusing. 

So I make it simple. 

As Your Insurance Broker, 

All your insurance is covered in one relationship,

saving you time and

building confidence for your future. 

If this was helpful to you, please: 

• “Like and Share” this post

• Follow me on social media (@appleinsurancesolutions)

• Contact me at peter@appleinsurancesolutions.com

Also, keep in mind, that as Your Insurance Broker,

I offer insurance for auto, home, life, health, medicare, umbrella and business… when you work with me, all your insurance needs... are in one relationship.

Thank you for reading HOW TO INSURANCE

Helping YOU understand insurance, 

building CONFIDENCE for your future! 

PETER D JOHNSEN

Insurance Broker | Apple Insurance Solutions

360.818.4865 OR/WA 818.620.8171 CA

appleinsurancesolutions.com  

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