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Medicare & Medicare Advantage


Medicare Advantage Annual Enrollment 2020
OCTOBER 15, 2019– DECEMBER 7, 2019

When can you join, switch or drop a Medicare Advantage Plan?

You can join, switch or drop a Medicare Advantage Plan at these times:

What is Medicare?

Medicare is Health Insurance for:

Your Medicare coverage choices at a glance

The different parts of Medicare

Medicare vs Medicare Advantage

What are Medicare Advantage Plans (Part C)?

A Medicare Advantage Plan (like an HMO or PPO) is another way to get your Medicare coverage. If you join a Medicare Advantage Plan, you still have Medicare. You’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies that Medicare approves.

Medicare Advantage Plans cover all Medicare services -

In all types of Medicare Advantage Plans, you’re always covered for emergency and urgent care. Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care and some care in qualifying clinical research studies. Original Medicare covers hospice care and some costs for clinical research studies, even  if you’re in a Medicare Advantage Plan.

What are the different types of Medicare Advantage Plans?

What is Medicare Supplement Insurance ?

Medicare Supplement Insurance policies, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Medicare Supplement Insurance policies are also called Medigap policies.

Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then, your Medigap policy pays its share. You have to pay the premiums for a Medigap policy.

What do Medicare Supplements (Medigap) policies cover ?

Medicare Supplement Plans

Medicare Part D – Prescription Drug Coverage

Part D coverage is offered through private prescription drug plans, or PDPs, which Medicare has approved. Part D coverage may be provided in two ways: a stand-alone plan (fee for service basis) providing prescription drug coverage to Original Medicare, or through a Part C plan that includes prescription drug coverage.
Individual Eligibility and Enrollment
Individuals must meet the following requirements to receive Part D benefits:

Individuals enrolled in Medicaid are automatically covered by Part D.
Individuals have two options for enrolling in a Part D plan:

Part D late enrollment penalty:

Coverages
A deductible of $435 in 2020 must be paid by the individual before the plan begins to pay.    Part D private prescription plans must meet minimum requirements, however monthly premiums can vary but may provide lower annual costs and more suitable drug tiers or formulary benefits from plan to plan.

Medicare Part D / Standard Benefit Parameters for 2020

Part D: CMS defined standard benefit levels