When you enroll in Original Medicare (Part A and Part B), you have the option of increasing coverage by purchasing a Medicare Supplement plan (also called Medigap). These plans work alongside Original Medicare and add financial benefits (like help paying for your copayments, coinsurance, and yearly deductibles).
Every state (except Massachusetts, Minnesota, and Wisconsin) has ten different types of plans. Each plan is represented by a different letter (A, B, C, D, F, G, K, L, M, and N). Plan F and Plan C are the most inclusive, and in turn, are the most popular. But did you know both plans are going away in 2020?
Plan F has been a top-seller in many states for years and is the most comprehensive Medigap plan. Medicare Plan F covers:
Blood work copays up to three pints (100%)
Foreign travel emergency (80%)
Hospice coinsurance and copayments (100%)
Part A coinsurance and hospital costs (100%)
Part A deductible (100%)
Part B coinsurance and copayments (100%)
Part B deductible (100%)
Part B excess charges (100%)
Skilled nursing facility coinsurance (100%)
Medicare Plan C Benefits
Medicare Plan C covers all of the gaps from Original Medicare except for Part B excess charges. More specifically, Plan C includes the following:
Blood work copays up to three pints (100%)
Foreign travel emergency (80%)
Hospice coinsurance and copayments (100%)
Part A coinsurance and hospital costs (100%)
Part A deductible (100%)
Part B coinsurance and copayments (100%)
Part B deductible (100%)
Skilled nursing facility coinsurance (100%)
Plan F vs Plan C
Plan F is very similar to Plan C. The only difference is that Plan C does not cover Medicare excess charges. If a doctor does not accept Medicare assignment rates, you will be responsible for excess charges, but it can not exceed 15% of what Medicare pays. Some states do not allow doctors to issue excess charges. If this is the case, Plan C will operate identically to Plan F.
Back in 2015, Congress passed the Medicare Access and CHIP Reauthorization Act. According to the act, starting on January 1, 2020, Medicare Supplement plans can no longer cover the Part B deductible, something that only Medigap Plans F and C currently cover.
When people don’t have to pay a deductible for services, they can end up overusing the doctor. For example, the might schedule an appointment with their doctor for a flu shot instead of using the free clinic inside their local grocery store. By visiting the doctor unnecessarily (and not paying for it), doctor’s offices are getting crowded and doctors aren’t being fully compensated for their time.
Eliminating Part B deductible coverage through Medigap works better financially for the Medicare program and for the doctors who accept it.
Thankfully, that Part B deductible is a small price to pay at $257 per year in 2025.
When will Medicare Plan F be discontinued? What about Plan C?
If you currently have Medicare Supplement Plan F or Plan C, don’t fret! This policy change only affects new beneficiaries. While your rates may increase (as they technically do every year), you will not lose your current coverage. However, if you leave your Medigap Plan F or Plan C for whatever reason, you will not be able to go back to it after 2020. If you do not have Plan F or Plan C, but you would like to, you can lock yourself in by enrolling NOW.
Due to this change, Plan F and Plan C beneficiaries will be given a chance to compare rates and switch to a new policy. If you decide you may want to switch, you can start by using our Medicare Plan Finder tool to decide what plan option (other than F) is best for you. If you still need help, click here to request a call from a local and licensed agent!
Will Plan F Costs Go Up in 2020?
It is certainly possible that Plan F costs will go up as it is phased out, though it hasn’t been confirmed yet.
Uniquely, the state of Idaho released a memo stating that the Idaho Department of Insurance “is NOT anticipating abnormally large premium increases on Plan F after 2020” in response to questions about Plan F leaving the market. Even people who already have Plan F in Idaho and want to switch to a different Plan F after this year should not face large rate increases.
Can I Get Plan F in 2025?
No, Medicare Plan F was discontinued back in 2020. If you already have Plan F, don’t worry – you can keep your coverage.
What is a good alternative to Plan F?
Many seniors and Medicare eligibles who already have Plan F are deciding to drop Plan F altogether and switch to Plan G. Plan G covers everything that Plan F does minus the Part B deductible, and it typically has a lower monthly premium.
Another popular plan is Plan N. The only benefit that is included in Plan G and not Plan N is the coverage for Part B excess charges. However, the thing to remember about excess charges is they are relatively rare. You will only be charged an excess charge if your provider does not accept Medicare.
Medicare Plan F vs Plan G
Great news! Plan G is almost identical to Plan F! The only difference is that Plan G does not cover the Part B deductible. Plan F may technically cover more, but many people consider Plan G to be a better value. Yes, you will need to pay your Part B deductible upon your first outpatient visit, but after you pay the deductible, you won’t need to pull your wallet out for the remainder of the year. Since you have to pay the Part B deductible yourself, Plan G has lower monthly premiums, and you could save more than $400 a year!
The standard Part B deductible for 2025 is $257, so the savings from choosing G over F significantly outweighs the cost of the deductible.
Is Medicare going away or just certain plans?
No, Medicare is not going away! Don’t panic!
Both Medicare Plan F and Medicare Plan C will be discontinued on January 1, 2020, but other options may be available in your area. We get it, Medicare coverage and plan options can be confusing and stressful. Policies are constantly changing, and healthcare will continue to evolve.
At Medicare Plan Finder, our agents are kept up to date on all the plans in your area and can help you find a plan that suits your needs and budget. If you’re interested in arranging a no-cost, no-obligation appointment, click here or give us a call at (833)-567-3163.
This blog was originally published on October 23, 2018, by Kelsey Davis. The latest update was updated on December 5, 2019, by Troy Frink.
How to Choose the Best Type of Medicare Plan for You
When it’s time to choose a Medicare plan, it’s easy to get overwhelmed. There are quite a few different types of Medicare plans to choose from. Once you choose what type you want – you still have to choose a plan! Making the right choice is important because it may not be easy to change plans if you change your mind.
The Annual Enrollment Period (October 15 through December 7) is when anyone can make changes, and for some people, it’s the only time. If you make the wrong choice, you might have to wait a whole year before you can change again (unless you qualify for the OEP or have a SEP).
Which Types of Medicare Plans are Best for Me?
To figure out which Medicare plan is best for you, ask yourself the following questions:
What specific medical services do I need coverage for (ex: lab tests, blood work, surgery, chemotherapy, dental, etc.)?
How much room do I have in my budget? Am I able to pay a little more to have more benefits?
Would I rather pay more on a monthly basis and pay very little when I visit the doctor, or is it better to pay a small amount every month but risk having higher copayments?
Who are the doctors and other providers who I want to be covered in my plan?
There are four main types of Medicare plans to consider when you begin your Medicare plan search. Start by comparing Original Medicare, Medicare Advantage, Prescription Drug Plans, and Medicare Supplements.
Keep in mind that you cannot have Medicare Advantage and a Prescription Drug Plan at the same time. You also cannot have Medicare Advantage and a Medicare Supplement plan at the same time.
Which plan or combination of plans works best for you?
Medicare Advantage: A private plan that you can purchase once you have Original Medicare. Can add additional benefits such as hearing, vision, dental, fitness, etc. Can include a prescription benefit.
Prescription Drug Plans: Another type of private plan that you can purchase once you have Original Medicare. Usually only includes a prescription benefit.
Medicare Supplements (Medigap): Another type of private plan that you can have in addition to Original Medicare. Adds more financial coverage, like for copayments and deductibles. This type of plan would also require you to have a stand alone part D drug plan.
Different Types of Medicare Plans
Choosing a Medicare Advantage Plan
So, did you decide to go with Medicare Advantage? Great! Now, there are a few types of Medicare Advantage plans that may be available for you. First, ask yourself whether or not you need a large network and whether the freedom to see any doctor is important to you. Then, read through these important differences:
HMO Plans (Health Maintenance Organization) – You’ll select one primary physician. In some cases, you may only receive coverage for that one doctor (unless he or she refers you to a specialist). Requirements may vary based on your plan.
HMO-POS Plans (Point-Of-Service) – You’ll select one primary physician, but you’ll have the freedom to visit any specialist in your network for your other needs. You will be charged a fee for visiting specialists.
PPO Plans (Preferred Provider Organization) – You can see any doctor, but your costs will usually be lower if you choose one that is in your network.
PFFS Plans (Private Fee-For-Service) – You will not need referrals or a primary physician, but you’ll have to pick a doctor that accepts your PFFS plan.
SNP (Special Needs Plans) – Designed for those who are eligible for both Medicare and Medicaid, live in a nursing home, or have a chronic illness or disability.
MSA (Medical Savings Account) – Works like a tax-free savings account for your medical bills. Medicare will deposit money into your HSA. You can use that account to pay for medical expenses.
How do I Pick a Medicare Supplement Plan?
If you’ve decided that you want a Medicare Supplement plan, you’ll want to start by selecting the plan letter that corresponds with the coverage you need. Use the chart below for reference.
Once you’ve made that decision, you may have a few different carriers available in your area to choose from (some smaller cities may not have several options available).
Finding Medicare Plans in your area just got easier. Our Medicare Plan Finder tool can help you not only see what is available, but see which options may be best for your unique needs.
You can enroll by yourself, or you can meet with a licensed agent (for free) who can walk you through the process to make sure you don’t make any mistakes. The licensed agent can also talk to you about a variety of different types of plans in your area and answer all your questions.
This unbiased approach is a great way to get the help you need when selecting a Medicare plan.
To set up your free meeting with a Medicare Plan Finder licensed agent, call 833-567-3163 or click here.
How to Use Medicare Plan Finder
How to Use Medicare Plan Finder and What Does it Cost?
Medicare Plan Finder has no cost and it’s as easy as 1,2,3!
STEP ONE: Review the plans available in your area by clicking here and entering your zip code.
STEP TWO: Compare the available plans in your area and see how they match up to your current plan.
STEP THREE: Choose your plan, and if you want, enroll directly online. Or, if you’re like most people, take a look at some plans and then call us directly at (833)-567-3163 and we’ll be happy to help you with next steps.
Our licensed agents will answer any other questions you have and can show you all the different plan options that you may qualify for. They are licensed to sell plans like Medicare Advantage, Medicare Supplement, Medicare Part D, ACA health insurance plans, burial insurance, and more.
Thank you for visiting MedicarePlanFinder.com (the “Website”), which is owned and operated by Medicare Health Benefits, LLC (“MedicarePlanFinder”). We recognize that your privacy is important and have created this Privacy Policy (“Privacy Policy”) to inform you about our data collection and use practices, including personal information that we collect from you and through your use of the Website and the services provided on the Website.
The Privacy Policy is presented to provide you information regarding the collection, storage and use of your personal information. Accordingly, please read this Privacy Policy carefully. This Privacy Policy may be changed by us from time to time without notice to you, and the governing version will be posted on the Website. Please review this Privacy Policy on a regular basis as your use of the Website will be governed by the then-current Privacy Policy. Please also be aware that this Privacy Policy does not apply to the practices of companies that we do not own and/or control or to people that we do not employ or manage.
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How we protect your information
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Notice to California residents – Your California Privacy Rights
We do not meet the definition of “business” under the California Consumer Privacy Act, and therefore, we are exempt from its requirements.
Thus, under California Civil Code Sections 1798.80-1798.84, because MedicarePlanFinder may in the course of business disclose a user’s personal information to any third party in its discretion, all California residents have the right to obtain what information and to whom the information was provided by MedicarePlanFinder in the immediately preceding calendar year. Upon written receipt of a written or email request for such information to the designated address below, MedicarePlanFinder shall provide a list of any disclosures of the California resident’s personal information to any third party within thirty (30) days of the receipt of such request. The list shall include:
1. A list of the categories of personal information disclosed to third parties for their direct marketing purposes during the immediately preceding calendar year; and
2. The names and addresses of all of such third parties that received the California resident customer’s personal information within the preceding calendar year and, to the extent we know, an indication of the third party’s business.
Such list may be in a standardized format and not specific to any individual.
A California resident’s request for such information may be submitted via e-mail to salessupport@medicarehealthbenefits.com or by mail to Privacy Matters, Medicare Health Benefits, LLC, MedicarePlanFinder.com, 6201 Centennial Blvd., Nashville, TN 37209 United States. California residents shall only be entitled to have this information provided once per calendar year.
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Medicare Supplement Plans in Montana: Your [mpf name="current_year"] Guide
If you’re a Medicare beneficiary in Montana, understanding Medicare Supplement plans, also known as Medigap, can help you manage out-of-pocket costs not covered by Original Medicare.
This guide will explain what Medigap plans are, their benefits, and how to choose the right one for your healthcare needs.
What Are Medicare Supplement Plans?
Medicare Supplement Insurance Plans are health insurance plans offered by private insurance companies to fill the gaps in Original Medicare (Medicare Part A and Medicare Part B). These plans help cover costs such as:
Coinsurance
Copayments
Deductibles
In Montana, as in other states, Medigap plans are standardized.
The federal Medicare program requires each Medigap plan to offer the same benefits regardless of the insurance company, making it easier to compare plan options. The only difference is the pricing the insurance company charges you.
The most popular plans include Plan G, Plan N, and Plan F (if eligible).
Popular Medicare Supplement Plans in Montana
Plan G
Plan G is the most comprehensive Medigap plan available to new Medicare beneficiaries. It covers:
Part A hospital coinsurance and hospital costs
Part B coinsurance or copayments
Part A deductible
Part B excess charges
The first three pints of blood annually
80% of foreign travel emergency expenses
The only cost not covered by Plan G is the annual Part B deductible, which is $257 for 2025.
Plan N
Plan N offers lower premiums than Plan G but requires some cost-sharing. Beneficiaries are responsible for:
Copayments for doctor office visits ($20) and emergency care ($50)
The Part B deductible
Plan F
Plan F provides the most comprehensive coverage but is only available to beneficiaries who were eligible for Medicare before January 1, 2020. It covers:
All Part A and Part B deductibles
Coinsurance and copayments
Part B excess charges
High Deductible Plan F
For those looking for lower premiums, the High Deductible Plan F offers the same benefits as Plan F after meeting a higher deductible.
Benefits of Medicare Supplement Plans
Predictable Costs: With a Medigap plan, you can avoid unexpected out-of-pocket expenses for coinsurance, copayments, and deductibles.
Nationwide Coverage: Medigap plans allow you to see any healthcare provider that accepts Medicare, offering flexibility for those who travel or live in multiple states.
Standardized Benefits: The benefits of each health plan are the same, regardless of the insurance company.
Peace of Mind: Enjoy comprehensive Medicare coverage for healthcare costs that Original Medicare benefits do not cover.
Foreign Travel Emergency: Some health plans, like Plan G and Plan F, cover a percentage of foreign travel emergency expenses.
Guaranteed Issue: During the Open Enrollment Period, beneficiaries cannot be denied coverage due to pre-existing conditions.
How to Choose the Right Plan in Montana
When selecting a Medicare Supplement plan, consider the following factors:
Budget: Compare monthly premiums and out-of-pocket expenses for each plan.
Healthcare Needs: Determine how often you visit doctors, require prescription drugs, or need skilled nursing facility care.
Eligibility: If you’re newly eligible for Medicare, Plan G and Plan N may be your best options.
Lifestyle: If you travel frequently, Medigap’s nationwide coverage and foreign travel emergency benefits are significant advantages.
Medicare Supplement Plan Costs in Montana
The cost of Medigap plans varies based on factors such as age, location, and the insurance company. On average, monthly premiums for Plan G in Montana range from $130 to $200. Plan N premiums are generally lower, ranging from $100 to $160. High Deductible Plan F offers lower premiums but comes with a higher deductible to meet before benefits begin.
Enrolling in a Medicare Supplement Plan
The best time to enroll in a Medigap policy is during your Medigap Open Enrollment Period, which begins the first month you are 65 or older and enrolled in Medicare Part B. During this period, you cannot be denied coverage due to pre-existing conditions.
Medicare Supplement Plans vs. Medicare Advantage Plans
Medicare Supplement plans are different from Medicare Advantage plans. While Medigap plans supplement Original Medicare, Medicare Advantage plans replace it. Here’s a quick comparison:
Speak with a Licensed Insurance Agent in Montana
Navigating Medicare Supplement plans can be confusing, but you don’t have to do it alone. Our licensed insurance agents in Montana are here to help you compare plans, explain your options, and find the best coverage for your needs and budget.
Contact Us Today:
Phone Number: (833)-567-3163
Medicare Supplement Plans in New Mexico: Your [mpf name="current_year"] Guide
If you’re a Medicare beneficiary in New Mexico, understanding Medicare Supplement plans, also known as Medigap, can help you manage out-of-pocket costs not covered by Original Medicare.
This guide will explain what Medigap plans are, their benefits, and how to choose the right one for your healthcare needs.
What Are Medicare Supplement Plans?
Medicare Supplement Insurance Plans are health insurance plans offered by private insurance companies to fill the gaps in Original Medicare (Medicare Part A and Medicare Part B).
These plans help cover costs throughout the calendar year such as:
Coinsurance
Copayments
Part A Deductibles
In New Mexico, as in other states, Medigap plans are standardized. This means each Medigap plan offers the same benefits regardless of the insurance company, making it easier to compare plan options. The only difference is the pricing each company charges you.
The most popular plans include Plan G, Plan N, and Plan F (if eligible).
Popular Medicare Supplement Plans in New Mexico
Plan G
Plan G is the most comprehensive Medigap plan available to new Medicare beneficiaries. It covers:
Part A hospital coinsurance and hospital costs
Part B coinsurance or copayments
Part A deductible
Part B excess charges
The first three pints of blood annually
80% of foreign travel emergency expenses
The only cost not covered by Plan G is the annual Part B deductible, which is $257 for 2025.
Plan N
Plan N offers lower premiums than Plan G but requires some cost-sharing. Beneficiaries are responsible for:
Copayments for doctor office visits ($20) and emergency care ($50)
The Part B deductible
Plan F
Plan F provides the most comprehensive coverage but is only available to beneficiaries who were eligible for Medicare before January 1, 2020. It covers:
All Part A and Part B deductibles
Coinsurance and copayments
Part B excess charges
High Deductible Plan F
For those looking for lower premiums, the High Deductible Plan F offers the same benefits as Plan F after meeting a higher deductible.
Benefits of Medicare Supplement Plans
Predictable Costs: With a Medigap plan, you can avoid unexpected out-of-pocket expenses for coinsurance, copayments, and deductibles.
Nationwide Coverage: Medigap plans allow you to see any healthcare provider that accepts Medicare, offering flexibility for those who travel or live in multiple states.
Standardized Benefits: The benefits of each plan are the same, regardless of the insurance company.
Peace of Mind: Enjoy comprehensive Medicare coverage for healthcare costs that Original Medicare doesn’t cover.
Foreign Travel Emergency: Some plans, like Plan G and Plan F, cover a percentage of foreign travel emergency expenses.
How to Choose the Right Plan in New Mexico
When selecting a Medicare Supplement plan, consider the following factors:
Budget: Compare monthly premiums and out-of-pocket expenses for each plan.
Healthcare Needs: Determine how often you visit doctors, require prescription drugs, or need skilled nursing facility care.
Eligibility: If you’re newly eligible for Medicare, Plan G and Plan N may be your best options.
Lifestyle: If you travel frequently, Medigap’s nationwide coverage and foreign travel emergency benefits are significant advantages.
Medicare Supplement Plan Costs in New Mexico
The cost of Medigap plans varies based on factors such as age, location, and the insurance company. On average, monthly premiums for Plan G in New Mexico range from $120 to $180. Plan N premiums are generally lower, ranging from $90 to $140.
Enrolling in a Medicare Supplement Plan
The best time to enroll in a Medigap policy is during your Medigap Open Enrollment Period, which begins the first month you are 65 or older and enrolled in Medicare Part B. During this period, you cannot be denied coverage due to pre-existing conditions.
Medicare Supplement Plans vs. Medicare Advantage Plans
Medicare Supplement plans are different from Medicare Advantage plans. While Medigap plans supplement Original Medicare, Medicare Advantage plans replace it. Here’s a quick comparison:
Speak with a Licensed Insurance Agent in New Mexico
Navigating Medicare Supplement plans can be confusing, but you don’t have to do it alone. Our licensed insurance agents in New Mexico are here to help you compare plans, explain your options, and find the best coverage for your needs and budget.
Contact Us Today:
Phone Number: (833)-567-3163
Medicare Supplemental Plans in Athens Tennessee
Did you know we call Tennessee home too? Our agents are here to help residents of Athens, TN determine which Medicare path makes most sense.
Navigating Medicare options doesn’t have to be overwhelming. Whether you’re exploring Medicare Supplement (aka Medigap) plans or looking into Medicare Advantage plans, understanding your options can help you choose the best insurance coverage for your needs.
Here, we break down the key information about both plan types to make your decision easier.
Why Medicare Supplement Plans (Medigap)?
Medicare Supplement plans are designed to fill the gaps in Original Medicare, providing additional insurance coverage for out-of-pocket expenses like copayments, coinsurance, and deductibles. These plans are standardized, meaning the benefits are the same regardless of the insurer you choose—making it easier to compare options. Medicare supplement plans are a popular choice for beneficiaries seeking peace of mind.
Plan G: Athens’ Top Choice for 2025
Plan G is the predecessor of Plan F which was discontinued a number of years ago. Plan G now consistently stands out as the best plan option for those individuals who are looking to both minimize out-of-pocket costs with their Medicare supplement and have predictability in their monthly budget.
While it doesn’t cover the annual Part B deductible (currently $257), it offers full coverage for:
Part A coinsurance and hospital costs
Part A hospice care coinsurance or copayment
Part A deductible
Part B coinsurance or copayment
Part B excess charges
The first three pints of blood annually
80% of foreign travel exchange expenses
Average Monthly Premium of Plan G
In Athens, the average monthly premium for Plan G is $145.75. However, premiums can vary depending on the insurance companies offering coverage. Medicare clearly states every year that every Medicare supplement plan of the same type must offer the same benefits, with the only difference being the cost.
Here are the cost ranges for Medicare plan G in Athens, TN.
Low: $98.48 / month
Medium: $145.75
High: $491.45
Plan N: A Cost-Effective Alternative
Plan N is another Medigap option that offers lower premiums while requiring copayments for some services. It’s ideal for those who don’t mind paying small copayments for doctor visits and emergency room care for an exchange of a lower premium.
Why Consider Medicare Advantage Plans?
Medicare Advantage (Part C) plans are an alternative to Original Medicare. These plans bundle Medicare Parts A and B and often include additional benefits such as:
Comprehensive Coverage: Many plans include additional healthcare benefits like fitness memberships and transportation to medical appointments.
Cost-Effective: Medicare Advantage plans typically feature lower premiums than Medigap plans, though costs like copayments and deductibles should be considered.
Prescription Drug Coverage: Most Medicare Advantage plans include built-in Part D coverage, eliminating the need for a separate prescription drug plan.
Considerations for Medicare Advantage in Athens, TN
Ensure your preferred doctors and specialists are in-network.
Review the plan’s drug formulary to confirm your prescriptions are covered.
Compare out-of-pocket maximums for different plans.
Check the plan’s availability in McMinn County and other nearby areas, including Knoxville.
Which Option is Best for You?
The choice between a Medicare Supplement plan and a Medicare Advantage plan depends on your healthcare needs, budget, and lifestyle.
Medicare Advantage is popular due to the many plans have little to no monthly premium. Each plan has it’s own copay schedule that explains the cost you will incur when you use your plan.
Medicare Supplement is popular for those individuals that want peace of mind that they aren’t restricted by a physician network and can budget their costs monthly due to the coverage supplements provide.
Get Help Finding the Right Plan
Choosing between Medicare Supplement and Medicare Advantage plans can feel overwhelming, but you don’t have to do it alone.
Our licensed Medicare agents are here to help you navigate your options, compare insurance plans, and find the best fit for your healthcare needs and budget.
Speak with a Licensed Medicare Agent Today
Call us or email us to learn more about your options in Athens, TN, and get personalized recommendations. We’re here to ensure you have peace of mind when it comes to your healthcare coverage.
Phone: (833)-567-3163
Other Cities in Tennessee
Aside from Athens, TN, we proudly serve residents across Tennessee. Explore Medicare plans in: Adams, Alcoa, Algood, Chattanooga, Knoxville, Memphis, Nashville, McMinn County, and more.
Additional Benefits with Medicare Advantage Plans: What You Need to Know
When exploring Medicare options, Medicare Advantage plans stand out due to their potential to offer benefits beyond what Original Medicare covers. These additional benefits can significantly enhance your healthcare coverage, but it’s important to remember that not all Medicare Advantage plans are the same. Each plan varies in the additional benefits offered, making it crucial for beneficiaries to compare plans carefully based on their health needs and preferences.
Understanding Medicare Advantage Plans
Medicare Advantage plans are offered by private insurance companies approved by Medicare. They provide all the benefits of Medicare Part A and Medicare Part B, often combined with other health services that Original Medicare does not cover. The inclusion of additional benefits is one of the primary reasons these plans have gained popularity among Medicare beneficiaries.
Types of Additional Benefits
Dental, Vision, and Hearing Care
Most notably, many MA plans include coverage for dental, vision, and hearing care—services not covered by Original Medicare. Dental benefits might cover routine check-ups, cleanings, x-rays, and even some types of dental surgery. Vision care often includes eye exams, glasses, or contact lenses, while hearing care might cover hearing aids and auditory exams.
Wellness Programs
Many plans incorporate wellness programs such as fitness memberships or discounts on health and wellness services. These benefits are designed to promote a healthy lifestyle among seniors, which can help prevent or manage common diseases associated with aging.
Over-the-Counter Allowances
Some MA plans offer allowances for over-the-counter (OTC) products such as vitamins, pain relievers, and first aid supplies. This benefit can be particularly helpful as it reduces out-of-pocket costs for everyday health items.
Telehealth Services
With the growing popularity of digital health services, many MA plans now include telehealth benefits, allowing beneficiaries to consult with healthcare providers from the comfort of their homes. This is especially beneficial for those with mobility challenges or those living in remote areas.
Transportation Benefits
Transportation to and from healthcare facilities can be a significant hurdle for many seniors. Some MA plans offer transportation benefits, which can be a deciding factor for those who do not have easy access to transportation or who are unable to drive.
Nutritional Support
Recognizing the importance of nutrition in health, some plans provide benefits aimed at nutritional support, including meal deliveries, especially after hospital stays, or nutritionist consultations to help manage dietary needs.
Choosing the Right Plan
When selecting a Medicare Advantage plan, consider the following steps:
Assess Your Health Needs: Understand your specific health requirements—do you need regular vision or dental services, or are you managing a chronic condition that might benefit from wellness programs?
Compare Plans in Your Area: Not all plans are available in every location, and benefits can vary widely between plans. Use the Medicare Plan Finder tool or consult with a licensed insurance advisor to compare the plans available in your area.
Read the Fine Print: Once you’ve narrowed down your choices, look closely at the plan’s summary of benefits to understand what is and isn’t covered, and at what cost. Pay attention to any specific limitations or rules regarding how you can use the benefits.
Check Provider Networks: Ensure that your preferred doctors and hospitals are included in the plan’s network. Medicare Advantage plans often have network restrictions, and going out of network can result in higher out-of-pocket costs.
Review Star Ratings: Medicare rates plans based on quality and performance. These ratings can help you understand the quality of care and customer service you can expect from different plans.
Conclusion
Medicare Advantage plans can offer a range of additional benefits that enhance your healthcare experience, but the key is to choose wisely based on your personal health needs and circumstances. By doing thorough research and understanding the specifics of each plan, you can find a Medicare Advantage plan that not only meets your health needs but also enhances your quality of life through additional benefits.
One survey about Medicare satisfaction vs. private insurance satisfaction found that people with Medicare were happier with their health plans than people with individual plans. Will you find the same to be true?
As you turn 65 or otherwise become eligible for Medicare, you probably have a lot of questions. What’s going to change? Will I lose or gain new benefits? The good news is that signing up for Medicare does not necessarily mean giving up your plan flexibility or your favorite doctors. There are plenty of Medicare options available, and we’ll explain why it’s worth it to go ahead and get signed up as soon as you can.
Employer Coverage
You can purchase health insurance through your employer, as long as it meets the coverage limits set by the federal government. If you’re retiring but aren’t eligible for Medicare yet, you can use COBRA to hold you over. COBRA allows you to continue receiving your employer coverage for a short period of time (but your employer likely won’t help you pay for it except for in some unique cases).
You can also technically have Medicare and employer coverage at the same time, if you become eligible for Medicare while you are still employed. That might make sense for some people and not others.
Private Coverage
You can purchase insurance from an exchange like Healthcare.gov, directly from your state, or directly from a health insurance company. Generally, purchasing private insurance is more expensive than employer coverage, and much more expensive than Medicare and Medicaid.
Medicaid
Medicaid is a federal health program. Each state has slightly different rules and each state has its own funding. The program can cover any person of any age with low income (according to the Federal Poverty Level and with some adjustments in each state). Most Medicaid beneficiaries will have either no or very small premiums. If you have a low monthly income AND are over 65, you may qualify for both Medicaid and Medicare! In that case, you can get what is called a “Dual-Eligible Special Needs Plan,” which is low-cost and tailored to your needs.
Medicare
Original Medicare is a federally funded health program that can cover any adult over the age of 65 as well as some adults with disabilities, such as end-stage renal disease.
Most people with Medicare will start with parts A and B. Part A provides hospital coverage, and Medicare Part B provides medical coverage. Anyone who wants more coverage can opt to enroll in either a Medicare Advantage plan or a Medicare Supplement (also called Medigap) plan. Medicare Advantage is sometimes referred to as “Part C” because you have to have Part A and Part B first to enroll in it, and it can cover a lot of services that parts A and B do not.
Unless you enroll in a Medicare Advantage plan that includes prescription drug coverage, you’ll want to enroll in a separate drug plan. These plans are referred to as “Medicare Part D,” because they are completely separate from the other “parts.” Part D plans only cover prescription costs.
Some people may qualify for no or low-cost Medicare coverage, but others will have to pay premiums. Most people will not have to pay nearly as much for Medicare as they would with an individual or private health plan.
You may think that individual plans provide more coverage due to the higher premiums, but that is not always the case. All Medicare plans include preventative services. Plus, you can choose to enroll in Medicare Advantage, which is like a private plan for Medicare. With Medicare Advantage, you can roll all your benefits – medical, dental, vision, prescription drugs, and even fitness – into one convenient plan.
How is Medicare different from other health insurance?
Medicare is vastly different from other health insurance options for a lot of reasons, ranging from the way you pay for your coverage to when you can enroll.
For starters, the Medicare enrollment period is different from the ACA enrollment periods and your employer’s enrollment periods. The Medicare Annual Enrollment Period runs from October 15 through December 7, but be sure to not confuse it with the ACA Open Enrollment Period, which runs from November 1 through December 15 of each year.
Another thing that is different is that some people can have their Medicare Part A payments automatically deducted from their Social Security check.
Employer Health Insurance vs. Medicare Plans
It’s hard to even compare Medicare plans vs. employer health plans because the only thing they have in common is that they provide health insurance. If you’re turning 65 or otherwise preparing to make the switch from your employer plan to Medicare, you should know the pros and cons of each option.
For starters, Original Medicare is the same for everybody. Technically, there are not separate plans to choose from within the government Medicare program. Once you’ve enrolled in Original Medicare, you can decide to add coverage through a private Medicare Advantage or Medicare Supplement plan. Some people may see this as a great thing because you can enroll right away without stressing about all your options. Others don’t like it, because one plan clearly cannot work for everybody. However, that’s what the private plans are for (and many of them are incredibly cheap compared to employer plans – some even have $0 premiums).
The advantage of private health insurance for Medicare (Medicare Advantage or Medicare Supplement) is that you can pick and choose which benefits are most important to you so that you aren’t paying for coverage that you don’t need. Plus, some people will qualify for Medicare Special Needs Plans which are specifically designed for people with special financial or medical needs and are usually relatively low-cost plans. Private Medicare plans can closely resemble individual marketplace plans or employer plans.
The disadvantages of private health insurance for Medicare-eligible people are that they sometimes have limited doctor networks and that some areas might have a limited number of plans to choose from. Typically, people who live in rural areas may have fewer plan options when it comes to private Medicare coverage.
Medicare vs. Medicaid
Both Medicare and Medicaid are government programs that are regulated by CMS (Centers for Medicare and Medicaid Services). They both provide health insurance for medically necessary services.
The main difference between Medicare and Medicaid is who qualifies. It is possible to qualify for both programs, but Medicaid qualifications are based on income while Medicare qualifications are based on age and disability. Another difference is that while the Medicare qualification rules are federal, Medicaid qualification rules can change slightly by state.
Medicare Versus Spouse Insurance
A lot of people who are newly qualified for Medicare wonder if it might be better to stay on their spouse’s insurance plan. The fact is, it depends on how good your spouse’s insurance is. However, if you do qualify for Medicare, Part A (the part that covers hospital costs) has a $0 premium for anyone who has worked and paid Medicare taxes for at least ten years. If you haven’t worked that long but your spouse has, you might still qualify. If that’s the case, there’s no reason not to go ahead and enroll in Medicare Part A as soon as you become eligible.
Additionally, if you wait too long to seek out further Medicare coverage, your costs may go up. You can be charged a penalty of up to 10% of your premium if you don’t enroll in Medicare Part B when you first become eligible. Plus, Medicare Supplement plans can charge more or deny coverage based on preexisting conditions if you wait too long to enroll. So if you think you might want to enroll in a Medicare Supplement plan, don’t wait too long to start looking.
Medicare vs Other Health Insurance: The Benefits
If you are eligible for Medicare coverage but considering alternative health insurance, you should start by learning what Medicare does and does not cover. Medicare Part A and Part B are the same for all who enroll. They cover preventative healthcare, like your annual wellness visits and flu shots at 100%.
Part A also covers 60 consecutive hospital days at 100%. After the 60th day, you’ll start to owe co-payments. Part B covers mental health, lab tests and X-rays, emergency transportation, and medical equipment.
Medicare A and B do not include prescription drug coverage, dental, vision, hearing, podiatry, or any service that is not deemed medically necessary either for treatment or prevention. For additional health coverage, millions of Medicare beneficiaries enroll in Medicare Advantage.
Since Medicare Advantage plans are owned by private companies, they can add in benefits like dental, vision, hearing, etc. – any of those extra benefits that you might be accustomed to from having private health insurance. Some Medicare Advantage plans also cover prescriptions. If you want prescription coverage but don’t care about all of the extra benefits, you can enroll in a stand-alone prescription drug plan instead. However, you cannot have both a Medicare Advantage plan and a Medicare prescription drug plan at the same time, so choose wisely.
The Costs of Medicare vs Other Health Insurance
The good news about Medicare is that as long as you or your spouse have worked and paid Medicare taxes for a certain number of years, your Part A Medicare costs will be low.
If you or your spouse has worked and paid Medicare taxes for at least 40 quarters, you’ll owe $0 in Part A premiums.
If you or your spouse has worked and paid Medicare taxes for less than 30 quarters, you’ll owe $518/month in 2025 in Part A premiums.
Part B premiums are standard for all Medicare beneficiaries. It can change each year, but the Part B monthly premium in 2025 is $185, and the deductible is $257. Most services that Part B covers are covered at 80%, so you may owe 20% coinsurance or doctor co-payments.
If you choose to enroll in a prescription drug plan, a Medicare Advantage plan, or a Medicare Supplement plan, you may face an additional premium.
Medicare vs. Private Insurance Costs
If you’re choosing between enrolling in Medicare Part B versus private insurance, remember that delaying your Part B enrollment can leave you with up to a 10% increase in your premium when you do decide to enroll.
If you decide to add on private Medicare insurance through a Medicare Advantage or Medigap plan, remember that you’ll still have to pay your Medicare Part A and B monthly premiums (unless you qualify for a savings program such as QMB). You cannot enroll in Medicare Advantage without enrolling in Medicare parts A and B first.
Medicare Advantage and Medicare Supplement plans are completely separate and therefore come with separate bills. You’ll owe a premium (which in some cases can be $0), and you’ll likely have a deductible as well as co-payments for certain services.
Many private health insurance plans also have out-of-pocket maximums, which means that if you have a lot of health care costs, you can reach a point where you stop having to pay out-of-pocket for services. Those out-of-pocket expenses can really start to add up even with Medicare if you’re someone who needs a lot of medical care!
Why is Medicare cheaper than private insurance?
A lot of new Medicare beneficiaries do find that their Medicare costs are cheaper than what they were paying before they qualified. The biggest reason for that is the way Medicare is funded. While you or your spouse were working hard for all those years, you were paying Medicare taxes. Your low premiums today are because of all that hard work! Plus, the Medicare office does not incur nearly the same amount of administrative costs that many healthcare companies do.
Is it better to have Medicare or private insurance?
Is Medicare a good insurance option? Is private health insurance better? It depends on who you ask. This is a great question to ask an insurance agent who knows what sort of medical expenses you have and what your budget is.
The main difference you have to remember when you’re wondering if private insurance or Medicare is better is that private insurance gives you more plan options. To get a private Medicare Advantage plan, you’ll have to enroll in Medicare A and B, first. Then, you can choose if you want to personalize your coverage and add benefits by enrolling in additional medical insurance.
If you’re stuck between Medicare and keeping your employer plan, remember that you could face penalties if you don’t enroll in Medicare when you first become eligible – and nothing says you can’t keep both!
Is Medicare or private insurance better for people with dependents?
If you have dependents, Medicare isn’t going to help you. But that doesn’t mean you shouldn’t enroll. Medicare only provides individual coverage – there are no family plans or spouse Medicare plans. However, your Medicare Part A might be free. If that’s the case, you might want to consider enrolling in Medicare for yourself first, and then taking a look at options for your dependents.
If you have access to an employer plan, do the math to figure out if it may be more cost-effective for you to have your group vs. individual Medicare Advantage coverage. In some cases, it might even make sense for you to keep both. If your Medicare Advantage premium is low enough, you can keep that for yourself but also hang onto your group coverage for as long as you can to support your family. An insurance agent can help you figure out what’s best for you.
Can I drop my employer health insurance and go on Medicare?
If you become eligible for Medicare while still receiving employer health insurance, you can and should still enroll in Medicare to avoid penalty fees.
First, find out if you’re currently in one of the Medicare enrollment periods. Medicare open enrollment is different from your employer’s open enrollment period.
If you just became eligible, you’ll have a few months for your “Initial Enrollment Period.” If you’re aging into the program, this period begins three months before your 65 birthday and ends three months after. If you’ve already missed that period, don’t panic – you can enroll for the first time from January 1 through March 31 of each year.
Once you’re enrolled, the “Annual Enrollment Period,” is when you can add or make changes to your Medicare coverage. It runs from 10/15 through 12/7 of each year. This period is not for enrolling in Medicare for the first time – it’s only for adding or making changes to your private Medicare coverage.
According to Medicare.gov, some people will be automatically enrolled in Medicare Part A upon becoming eligible. If you are not automatically enrolled, you can apply for Medicare on the Social Security website.
How Medicare Works with Other Insurance
Millions of Medicare beneficiaries opt to enroll in Medicare Advantage or Medicare Supplements on top of their Medicare coverage. In these cases, the private insurance companies act as the “secondary payers.” Health benefits that Medicare does not cover will be automatically billed to the private company, but anything else will go to Medicare first. If you have both employer insurance and Medicare, Medicare might actually be the secondary payer. Check with your employer or your employer’s health insurance plan to be sure.
Both Medicare and private insurance coverage will have limitations – so having both is a great way to keep yourself and your families financially covered in case of a medical emergency.
How Medicare Plan Finder Can Help You
We specialize in Medicare and serving the underserved senior and Medicare-eligible population. Do you or a loved one need help selecting a Medicare plan that truly helps? Set up a free appointment with one of our licensed agents in your area to get bias-free assistance.
