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Medicare Supplement Plans

Medigap, also known as Medicare Supplement Insurance, helps cover some of Medicare’s out-of-pocket costs, which can include deductibles, copayments and coinsurance.

8 Things to Know About Medigap Before You Enroll

Before you enroll in a Medigap plan, read through the following information to ensure you understand how it works and get the most from its benefits.

  1. During your open enrollment period, you cannot be denied a Medigap policy, even if you have a preexisting condition or other medical issues.

  2. If you fail to enroll in Medigap during your six-month open enrollment period, insurance companies can charge you more for your plan or refuse to cover you at all based on your health.

  3. Don’t get Medigap plans A, B, C and D confused with Medicare Parts A, B, C and D.

    Medicare Part A and Part B make up Original Medicare.

    Medicare Part C is known as Medicare Advantage and is sold through private insurance companies as an alternative to Original Medicare.

    Medicare Part D plans are prescription drug plans sold through private insurers to help beneficiaries cover the cost of prescriptions.

  4. You cannot be enrolled in Original Medicare and a Medicare Advantage plan at the same time.

  5. You cannot be enrolled in a Medicare Advantage plan and a Medicare Supplement Insurance plan at the same time.

  6. You can be enrolled in a Medicare Supplement Insurance plan and a Part D prescription drug plan at the same time.

    You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

  7. Medigap plans that share a letter will provide the same basic benefits no matter which state you purchase them in.

    For example, a Medigap Plan F policy purchased in Virginia will have the same basic benefits as a Medigap Plan F policy purchased in California. 

  8. The price you pay for a Medigap plan may vary based on several factors, including your location and insurance company.

    So although the basic benefits remain the same no matter where you purchase your policy, the price you pay for those benefits can vary greatly.  

Call today to speak with a licensed insurance agent who can help you compare Medigap plans available in your area so that you can find the best Medicare Supplement plan for your needs.

Medicare Advan

Medicare Advantage plans may offer additional benefits that may not be available through Medicare Parts A and B. Medicare Advantage plans are offered through private insurance companies and can be customized for your own unique needs. There are different types of Medicare Advantage plans: Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), Private Fee-for-Service Plans (PFFS), Special Needs Plans (SNP), Medicare Medical Savings Account Plans (MSA) and HMO Point of Service Plans (HMOPOS).

One important difference between them is where you can get covered treatment. A Preferred Provider Organization has what is commonly referred to as a network of coverage. This means that there is a network of preferred facilities and physicians that are pre-approved for coverage with your plan. As long as you stay within this network, you will not incur any unexpected costs from covered procedures and examinations. The Medicare Advantage Plan you choose can also make a difference in your out-of-pocket costs and have may have different rules for how you get certain services like whether you need a referral to see a specialist.

Health Maintenance Organizations have a network of pre-approved service providers that will be covered within your plan, however, one main difference is that in most cases you must select a primary care physician. This primary care physician acts as your personal doctor, but also as your health care coordinator. If you ever needed to see a specialty doctor who was not in your HMO plan network, your primary care physician could offer you a referral if they deemed it necessary. You may need to obtain a referral from your primary care physician in order for the service to be covered.

By knowing what doctors are important to your healthcare, you can make a much more informed decision about what plan will serve you best. Find more information on the different Medicare Advantage Plan options at Medicare.gov.

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Education

Medical School - University of Dulton Health Science Center.

Residency in Family Medicine - University of Dulton Health Science Center.

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