Additional Coverage For Complete Protection
Supplemental plans are exactly that — supplemental. These insurance policies help fill in the gaps of original Medicare plans. Our agents will determine which Medicare supplement plans pay the most of your out-of-pocket expenses with the lowest monthly premium.
We offer both Medigap Supplemental Insurance with a Standalone Part D Plan and Medicare Advantage (MA-PD), such as an HMO or a PPO. What’s the difference between the two? With Medigap, there is no yearly maximum out of pocket cost for the health portion. It’s the most comprehensive major medical plan with no referrals or prior authorization needed. Medicare Advantage (MA-PD) offers monthly premiums as low as $0 or “pay as you go”. However, they do have yearly maximum out-of-pocket costs. Plans may change from year to year, with prior authorizations required, and plans aren’t specifically tailored to your own health needs.
Here’s a full comparison:
Medigap (Supplement) With a Standalone Part D Plan
- Fills in the gaps where Original Medicare stops (80/20)
- Most comprehensive major medical plan
- There is no yearly maximum out-of-pocket (MOOP) for the health portion
- Plans do not change from year to year
- No referrals are needed
- No prior authorization is required
- No networks; you can see any doctor in the country who accepts original Medicare
- There is no 20% co-insurance for chemotherapy
- Up to 100 days are included in skilled nursing
- No co-pays for physical therapy, occupational therapy, or chiropractic visits
- No hospital co-pays
- No co-pays for tests, labs, X-rays, etc
- Add a standalone drug plan (Part D) tailored to your specific health needs
Medicare Advantage (MA-PD), such as an HMO or a PPO
- Monthly premiums are available for as low as $0. It’s “fee for service,” or “pay as you
- There is a yearly maximum out-of-pocket (MOOP) for the health portion only. HMOs
average $6,700, PPOs $10,000 (in/out of network).
- Plans may change from year to year
- Referrals are usually needed with HMOs, but not with PPOs
- Prior authorization may be required
- There are narrow provider networks with HMOs. If you travel, a national carrier with a
travel benefit or a PPO is recommended.
- With an HMO, you must stay in-network, except in an emergency. With a PPO, you can
go out of network, but usually at a higher cost.
- 20% co-insurance for chemotherapy
- 20 days are included for skilled nursing, after that you pay $171.50 days 21- 100 (2019)
- There are co-pays for physical therapy, occupational therapy, or chiropractic visits
- You will have hospital co-pays, either daily or per stay
- There are co-pays for tests, labs, X-rays, etc
- Most plans have Part D plans embedded in them, but they are not specifically tailored to
your own health needs