With over 57 Medicare products available in our area, seniors face a complex decision that must account for their unique healthcare needs. Understanding that Medicare is not a one-size-fits-all solution, I am dedicated to assisting seniors through this intricate selection process. My goal is to ensure you choose a Medicare program that is precisely tailored to your individual health requirements and financial situations.

Why you need a Medigap (Supplement) or Medicare Advantage Plan

Having a Medigap (Supplement) plan or Medicare Advantage plan alongside your original Medicare plan is important for several reasons:

  1. Coverage Gaps: Original Medicare covers about 80% of medical costs, including doctor’s visits, medical treatment, and diagnostic exams. However, it does not cover the remaining 20%, which can be significant, especially in the case of extended hospitalization or expensive treatments.
  2. Out-of-Pocket Expenses: Medigap plans help cover out-of-pocket expenses like copayments, coinsurance, and deductibles that are not covered by original Medicare.
  3. Additional Benefits: Medicare Advantage plans often offer additional benefits such as dental, vision, and hearing coverage, which are not typically covered by original Medicare.
  4. Choice of Providers: With a Medigap plan, you have the freedom to see any doctor that accepts Medicare. Medicare Advantage plans may have network restrictions, but they can also provide a more comprehensive package of services, sometimes at a lower cost.
  5. Budgeting: Both types of plans can help you better predict your annual healthcare costs by capping out-of-pocket expenses.
  6. Prescription Drug Coverage: Some Medicare Advantage plans include prescription drug coverage, which is not covered by original Medicare and would otherwise require an additional Part D plan.

It’s important to compare the costs and benefits of Medigap and Medicare Advantage plans to determine which is the best fit for your healthcare needs and budget. Remember, Medigap is a supplement to original Medicare, while Medicare Advantage is an alternative way to get Medicare benefits. Each has its own set of rules, costs, and coverage options.

In 1965, the federal government created Medicare, a health insurance program for individuals aged 65 and over, without considering income, medical history, or health status. By 1972, the program expanded to include certain individuals under 65 with long-term disabilities. Currently, Medicare provides essential health and financial security to 60 million older adults and younger individuals with disabilities.

Medicare covers a wide range of medical care services, such as:

  • Hospital stays
  • Doctor’s appointments
  • Medications
  • Preventative care
  • Care in skilled nursing facilities and at home
  • End-of-life care

Individuals aged 65 and over generally qualify for Medicare Part A without a premium if they or their spouse have made Social Security contributions for at least 10 years. Additionally, people under 65 may qualify for Medicare benefits through Social Security Disability Insurance (SSDI).

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We do not cover every Medicare plan available in your area. Currently, I represent 8 organizations which offers 57 products in your area. Please contact or 1-800-Medicare or your local State Health Insurance Program (SHIP) to get all of your options.