What is Medicare?

Medicare is the federal health insurance program for: People who are 65 or older, certain younger people with disabilities, people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or an organ transplant) often called ESRD.

What is Medicare Advantage?

Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all Part A and Part B Medicare benefits. Most Medicare Advantage Plans also offer prescription drug coverage. 

Medicare Advantage Plans have a maximum out-of-pocket limit of $6,700 for in-network services and $10,000 for out-of-network services. After reaching the limit, Medicare Advantage plans pay 100% of eligible expenses. Most plans require you to visit their own network of doctors and health providers for services.

What are Medicare Supplements?

Medicare Supplements, oftentimes referred to as "Medigap" insurance, are private health insurance plans that helps fill the"gaps" in Original Medicare and is sold by private health insurance companies. 

Medicare Supplements require a monthly premium and helps pay some remaining health care costs, services, and supplies that Original Medicare does not cover, such as: 

  • Co-payments

  • Coinsurance

  • Deductibles

What is Medicare Part D Prescription (PDP) Drug Coverage?

Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs through prescription drug insurance premiums.

Medicare Part D reserves the right to levy penalties against an insurer if the insurer doesn't have Part D, or creditable drug insurance coverage, at the appropriate time.  The penalty is calculated by multiplying 1% of the "national base beneficiary premium" ($32.74 in 2020) times the number of full, uncovered months.

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