Medicare Doesn’t Have to Be Complicated

Whether you have Medicare now, or you will be enrolling into the program soon, you have many choices in today’s health care environment.   It is important to select a plan that fits you personally, in both coverage and cost. There is not a not a “one size fits all” plan. It does not matter what Medicare plan your spouse, friend or neighbor has. Your decision will be based upon needs and preferences.

Medicare can be confusing, which makes it hard to compare options and make a sound decision. It is important to understand and explore all your available Medicare options so you can make the best decision for yourself.

Because of your health needs and income change over time, it makes sense to revisit your Medicare plan benefits and costs each year.


  • Do you want the choice of any provider or are you willing to choose a provider from within a provider network?
  • Would you rather buy a separate prescription drug plan or get drug coverage included in one plan?
  • Would you rather pay more in monthly premiums and have lower out-of-pocket costs for services you receive or pay a low or $0 monthly premium and co-pays for services as you use them
  • Are you planning to travel in your retirement to visit family and friends and therefore will need nationwide coverage?
  • What are your health needs?
  • What is your budget?


How Medicare Works

Medicare is a federal health insurance program for eligible adults 65 and older and for those under 65 with a medical disability who qualify. Medicare has four parts — Part A, Part B, Part D and Part C. There’s also Medicare supplement insurance, known as gap insurance or Medigap. It helps cover the gaps in your Medicare coverage as well as your share of the costs for Medicare services.

There are two ways to receive your Medicare coverage: Original Medicare (Part A and Part B) or a Medicare Advantage plan (Part C).

Original Medicare =Part A+ Part B

Medicare Part A acts as hospital insurance. Part A helps pay for inpatient care in hospitals, hospice care, home health care and care provided in a skilled nursing facility if you meet certain requirements. If you or your spouse paid Medicare taxes when you were working, the federal government may pay your premium (monthly fee) for Part A coverage. If ineligible, you can still purchase Part A.

Medicare Part B provides medical insurance. Part B helps cover doctor visits, procedures that don’t require an overnight hospital stay and some preventive care services, such as flu shots. Most people pay a monthly premium for Part B, which is based on their income.

Original Medicare has gaps including deductibles, copays and coinsurance plus it doesn’t cover most prescription drugs or custodial care, such as nursing home stays.

Medicare Part D helps cover your cost for prescription drugs if you have Original Medicare. Part D plans are managed by private Medicare-approved insurers. You must enroll in a private plan to receive Part D services. Part D covered drugs generally:

  • Vary plan to plan
  • Include commonly used brand-name and generic drugs
  • Don’t cover over-the-counter medicines

Medicare Supplement Insurance (Medigap) are private health insurance plans that help pay for the “gaps” in coverage left by Original Medicare including copayments, coinsurance, and deductibles.  In many cases, someone with traditional Medicare must purchase a separate Part D drug plan as well as a Medigap plan to supplement their Medicare benefits. Medigap policies do not work with Medicare Advantage plans (MA) and it is illegal for anyone to sell an MA enrollee a Medigap policy unless they are switching to Original Medicare

Medicare Part C, or Medicare Advantage, integrates Medicare Part A and Part B coverage with additional medical benefits not covered by Original Medicare. Many Medicare Advantage plans include Part D drug benefits. When you enroll into a Medicare Advantage Plan you are simply choosing to assign the administration of your Medicare benefits to a private insurer and will receive your benefits through the plan you join.


2 Ways to Obtain your Medicare Benefits


Medicare can be confusing, which makes it hard to compare options and make a sound decision. It is important to understand and explore all your available Medicare options so you can make the best decision for yourself. If you would like help with your Medicare insurance options call 1-800-979-0266.