Medicare: Your Choices

Original Medicare combines Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). For those seeking additional benefits, there are Medicare choices such as joining a stand-alone Medicare drug plan that provides mandatory Prescription Drug Coverage (Part D). You can see any doctor or hospital that accepts Medicare throughout the U.S. To help manage out-of-pocket expenses in Original Medicare, like your 20% coinsurance, you might want to consider Medigap plans for supplemental coverage. It's important to note that Original Medicare does not cover everything, and for those with specific healthcare needs, Special Needs Plans may also be an option.

Supplemental coverage, commonly known as Medigap, is additional insurance you can purchase to help cover services and out-of-pocket expenses that Original Medicare may not fully address, such as deductibles and co-insurance. These Medigap plans are standardized and typically labeled by letters, such as Plans A-N. To make informed Medicare choices, it’s important to compare these plans to determine which one best suits your needs. Explore available policies in your area, as the main difference among the same letter plans from various companies is their price. If you're looking for help navigating these options, including Medicare Advantage, Prescription Drug Coverage, or Special Needs Plans, contact TBrown Insurance. There is no obligation and no cost to you!

Medicare Advantage plans are Medicare-approved alternatives provided by private insurance companies, offering different Medicare choices for your health and drug coverage. These plans typically combine Parts A and B and often include Prescription Drug Coverage (Part D). In many instances, you'll need to use doctors within the plan's network. Medicare Advantage plans may also feature lower out-of-pocket costs than Original Medicare and can provide additional benefits that Original Medicare doesn't cover, such as vision, hearing, and dental services. Additionally, for those with specific needs, Special Needs Plans are available as part of the Medicare Advantage offerings, while Medigap plans can further help cover costs not included in your Medicare benefits.

All Medicare Advantage plans must cover a wide range of prescription drugs that people with Medicare take, including most drugs in certain protected classes. The list of covered drugs in these plans is referred to as a "formulary," and each plan has its own unique formulary. When exploring Medicare choices, you’ll notice that many plans categorize drugs into different levels, known as "tiers." Each tier reflects a different cost structure. For instance, a drug classified in a lower tier will typically cost you less than a drug in a higher tier.

Example:

Tier 1 - lowest co-payment: preferred generic drugs

Tier 2 - medium co-payment: most generic drugs and some brand name

Tier 3 - higher co-payment: preferred brand name drugs

Tier 4 - higher to highest co-payment: mainly brand name drugs and some specialty drugs

Tier 5 - highest co-payment: specialty drugs

Some plans, including certain Special Needs Plans, might have a 4-tier system, while others may expand to as many as 6 tiers. Understanding your options for Medigap plans or Prescription Drug Coverage is essential to making the best choice for your health care needs.

We can explore adding a Medigap plan to Original Medicare along with a standalone Prescription Drug Coverage Plan. 

Maybe a straightforward Original Medicare option will suit you better with a standalone Prescription Drug Coverage Plan. 

We can also examine Medicare Advantage options, which often include health coverage and, in most cases, Prescription Drug Coverage. Medicare Advantage Plans (MAPD) come with additional benefits such as dental, vision, hearing, over-the-counter drugs, and more. For those with unique needs, Special Needs Plans may also be available. 

The choice is yours, but if you need assistance, talking to someone about your Medicare choices can be beneficial. This service is free for you. Remember, this is not a call center; our independent agents prioritize your specific medical and financial needs to ensure you select the right coverage. 

And the support doesn’t end there. TBrown Insurance will be available to answer any questions you may have after you choose the right plan. It all begins with a simple phone call!