Medicare 101 – Medicare Coverage Options

Medicare 101 medicare coverage options graphicMedicare can be a confusing topic. That is why Medicare Solutions is here to help free of charge. Medicare Health Insurance is offered uniformly throughout the country. We offer our service throughout the United States and have the experience to help you make an informed decision about Medicare Health Insurance. Here is a quick overview of your options. To get things started and further go into depth about your options, give our licensed sales agents a call today.

The Medicare Alphabet

  • Part B
    • Medical- Part of Original Medicare
    • Monthly Premium
    • Annual deductible and you pay 20% after meeting the deductible
  • Part D
    • Prescription Drug Coverage
    • Through prescription drug plan carriers

You Have Options for Additional Coverage beyond Original Medicare

First Option
Medicare Advantage Plans (Part C)

  1. Helps cover Part A, Part B, and may include Part D of Medicare
  2. All plans approved by Medicare
  3. Generally have a monthly premium per month
  4. Additional advantages (routine vision, fitness programs)
  5. Available through national/regional private insurance carriers
  6. Most plans include prescription drug coverage

Second Option
Supplement or medigap plans

  1. Added to Original Medicare
  2. Pays the cost sharing associated with Medicare
  3. Plans are standardized by Medicare
  4. Premiums may start at about $110 per month
  5. Available through private insurance companies

Medicare Prescription Coverage (Part D)

  1. Available through stand-alone prescription drug plan or as part of a Medicare Advantage Plan
  2. Different plans may have different cost-sharing levels
  3. Plans may have deductibles
  4. Plans may cover prescription drugs in the gap
  5. Most plans have in-network retail and mail order pharmacies

How Part D Works

The below is an example and does not represent a specific plan.

You Pay Co-Pay Retail Price
$7 $100
$29, etc. $250, etc.

When the co-pay and the plan’s share for each covered drug, plus the deductible, totals $3,700 in 2017*, you are in the Donut Hole or Coverage Gap.  Once you reach the coverage gap you will pay no more than 40% in 2017 of the plan’s cost for covered brand-name prescription drugs.  Although you’ll pay no more than 40% in 2017 for the brand-name drug, 95% of the price – what you pay plus 50% manufacturer discount payment – will count as out-of-pocket costs which will help you get out of the coverage gap.  In 2017, Medicare will pay 49% of the price for generic drugs during the coverage gap.  You’ll pay the remaining 51%.  Find more details at medicare.gov.

*This does vary by plan.

Let Medicare Solutions compare plans for you so you can get the Medicare Health Plan that meets your health and financial needs. No one should expect all this information to be familiar. That is what we are here for. It can all get a little overwhelming at times, we understand. Medicare Solutions is here to assist you in the process to find what suits your individual needs. We take the time to talk to you for however long it may take until you are satisfied and comfortable with the choices. Medicare Solutions is about personal attention. You speak with a live insurance specialist, not a computer. Call us at 844-839-0813 to start the process of gaining the information and attention you deserve to make the best decision about Medicare Health Insurance for you.

Medicare is sometimes confused with Medicaid. Click here to learn more about the difference between Medicare and Medicaid.