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What is Medicare Advantage?

Medicare Advantage is also referred to as Part C with Medicare. You must maintain your Medicare Part A and Part B coverage through Original Medicare to be able to keep your Medicare Advantage plan in force.

Medicare actually pays a fixed amount for your care every month, i.e. premium, to the companies offering Medicare Advantage Plans. These companies are contracted with and must follow rules set by CMS or Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care). These rules can change each year.

A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies contracted and approved by Medicare.

By joining a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D) as well.

We work with the following companies and their Medicare Advantage plans, LOCAL COMPANIES: Blue Cross of Idaho, Select Health, Pacific Source NATIONAL COMPANIES: United Healthcare, AETNA, Humana

Most Advantage plans include a Part D Prescription Drug plan and other benefits such as Dental, Vision, Hearing, Over the counter discounts, TeleHealth, Health Club Memberships, Transportation to and from the Doctor or Pharmacy etc.

If you have questions about what is best for you or want help making the decision give us a call, email or fill out a card on our website and someone will be in contact with you usually immediately or within 12 hours.

Why Medicare Advantage?

Gives you a full spectrum of benefits from medical, dental, vision. Low monthly premium IF ANY, Copays and Coinsurance if service is needed, Max out of pocket so you know how much your medical $ out of pocket could be if worst came to worst.

What is a Medicare Supplement or Medigap Plan?

Original Medicare provides very beneficial coverage for health related expenses however, at the same time, leaves gaps that you either pay for out-of-pocket or with private insurance. Those gaps are generally 20% of any outpatient, Part B, bill with NO out of pocket Maximum. A Medicare Supplement (also known as Medigap) insurance policy is a health insurance policy sold by a private insurance company to help fill in those gaps, i.e. Plan F , Plan G, Plan N. These are different levels of coverage with different pricing. They cover medical needs only and do not include the extras that Medicare Advantage plans offer.

With Medicare Supplement/Medigap insurance, there are no restrictive networks. You choose the physicians, specialists, and hospitals that you trust for your care. You can go directly to the physicians you choose without pre-certifications and pre-approvals. The benefits offer predictability and stability as the plans are standardized by the government but the pricing is dictated by the company. You have coverage that helps with deductibles, copayments, and coinsurance if any.

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With a Medigap/Medicare Supplement you can go to any doctor, facility etc. in America that takes Medicare and or Medicare Assignment.

*When you have a Medigap/Medicare Supplement plan you will need a Stand Alone Prescription Drug plan to go along with it since they are not included. These plans can cost from $13.00 a month to $100.00 a month depending on your circumstances. They also have a $435.00 deductible for Drug Tiers 3, 4 and 5. The companies we represent are Wellcare and Humana.

Why Medigap/medicare Supplement?

Basically, your monthly premium is your medical budget for the year with exception of a possible $198 deductible depending on the plan you have, You can go anywhere in the country that takes Medicare and or Medicare Assignment, no referrals required.

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