Medicare Guidance

Navigating Medicare coverage can feel overwhelming. Helping individuals understand their Medicare options and compare available plans to make informed decisions is my top priority. Whether someone is approaching age 65, exploring Medicare Advantage plans, or considering a Medicare Supplement (Medigap) plan and/or Prescription Drug plan, I am committed to helping clients understand their choices and find coverage that fits their needs and budget.

As an independent agent, I represent multiple carriers and can explain coverage options in the area and the differences between plans.

-- Plan availability and benefits vary by carrier, county and plan. I may not offer every plan available in the local area --

Medicare Advantage Plans (Part C)

Medicare Advantage plans are offered by private insurance companies approved by Medicare. They include all of Part A (Hospital) and Part B (Medical) coverage in one plan.

Many plans also include:

  • Prescription drug coverage (Part D)
  • Dental, vision and hearing benefits
  • Fitness memberships
  • Transportation assistance
  • Wellness programs

Medicare Advantage plans offer an alternative way to receive your Medicare benefits, often with additional coverage.

Benefits and costs vary by plan and service area.

Medicare Supplement (Medigap) Plans

Medicare Supplement plans (also called Medigap) are private insurance policies that help pay for costs that Original Medicare does not cover.

These gaps include:

  • Deductibles (Part A and Part B)
  • Coinsurance and copayments
  • Excess charges (providers that bill above the Medicare approved amount)
  • Foreign travel emergency (offered by some plans)

Without a supplement, Original Medicare has no out-of-pocket maximum, so a major illness or hospital stay can get expensive. Medigap plans cap or significantly reduce that exposure, making costs more predictable.

Plans are standardized by letter (A, B, D, F, G, K, L, M, N). Plan F is only available to those who became eligible for Medicare before January 1, 2020. 

Note: Medigap plans do not include prescription drug coverage. A separate Part D plan is needed.

Note: Monthly premiums apply in addition to Part B premium (and Part A premium if you have one) and vary by company and location.

Prescription Drug Coverage Plans (Part D)

Part D plans cover prescription drugs. They are sold by private insurance companies, and fill the gap left by Original Medicare, since Parts A and B cover very little outpatient medication. Plans typically include:

  • Formulary: a list of covered drugs usually sorted into tiers (generics cost least, specialty drugs the most)
  • Monthly premium, deductible, and copays or coinsurance vary by plan
  • An annual out-of-pocket cap on covered drugs applies, after which you pay nothing for covered drugs that year (amount set by Medicare each year)
  • Pharmacy networks: costs can differ depending on where prescriptions are filled

Drug lists and costs vary by plan.

Note: Standalone Part D plans can pair with Original Medicare and Medigap, or have drug coverage bundled into a Medicare Advantage plan.

Dental, Vision & Hearing

Original Medicare does not cover routine dental, vision or hearing care, but there are ways to add it.

  • Standalone plans: Separate dental, vision or hearing plans can be purchased from private companies, and paired with Original Medicare
  • Medicare Advantage (Part C): Many plans include dental, vision and hearing benefits, often at no additional premium. Benefits vary by plan.

Note: Medigap plans do not include dental, vision or hearing coverage.

Coverage and annual limits vary by plan.