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Nov. 28, 2022

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Original Medicare, Medicare Advantage and Medicare Supplements Explained

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If you’re on Medicare you probably receive little to no email regarding plans from different companies and agencies, right? WRONG! There’s so much information being mailed to you it’s probably hard to discern what’s what. It’s all so confusing! There are a lot of aspects to Medicare and with so many different options under one umbrella it can be hard to know which type of plan is right for you to help pay for what Original Medicare doesn’t. So, your first step is to ascertain if you would like a Medicare Advantage plan or a Medicare supplement. At Your Insurance Gal Agency we cut through all the confusion from the telemarketers and junk mail.

Here are the basics of how the primary parts of Medicare work: Under Original Medicare, you get your benefits directly from the federal government. Original Medicare includes two parts, Part A and Part B. If you have a qualifying work history, your Part A benefits are premiumfree. Medicare Part B premiums are set each year by the federal government and most people pay the same standard rate. In 2023 the base rate will be $164.90 which is a reduction from the 2022 rate. Some high earners (fewer than 5%) pay an income-related adjustment in addition to the standard Part B premium. Conversely if you have limited income & assets you may qualify for help in paying your Part B premium as determined by your state’s Medicaid office.

Medicare supplements partner with Original Medicare. Envision it as a second insurance coverage that helps pay for gaps in your Original Medicare coverage, hence the interchangeable term “Medi-Gap.” A Medicare supplement works to pay for the costs that normally Medicare would pass on to you (like your 20% coinsurance). If you purchase this type of policy, Medicare will first pay its share of your medical expenses. Then your Medigap policy will step in and pay its share. This is usually, the remainder of your bill or a good part of it. However, it depends on which policy you choose from the standardized plans which offered by private companies under the rules of the Medicare department. If you choose to supplement your Original Medicare in this way you must also purchase Part D which provides prescription drugs plans for an additional cost again through private companies.

Medicare Advantage is a popular alternative to Original Medicare. It’s very similar to group health insurance that you’ve had during your working years. It is essentially a major-medical plan which will include prescription drugs unless you have the option of get prescriptions through another source (such as the Veterans Administration) that has comparable or better coverage. These plans have networks and you pay for medical services as you go along. Medicare Advantage is also known as Medicare Part C. It is technically still a part of Medicare, but it is not sold or managed by the federal government. The government sets rules and guidelines, but private insurance companies sell and administer the plans.

There’s more to learn so if you still have questions about which might be right for you let the team at Your Insurance Gal Agency help you find the best Medicare solution to fit your unique set of circumstances and needs. We know what path to take based on your county of residence, income, health challenges, current physician, medication needs, and lifestyle.

Your Insurance Gal Agency

Open 9am to 5pm Monday – Friday
(Evenings and Saturday by appointment)
113 NE 92nd Ave, Vancouver, WA 98664
Website: YourInsuranceGal.com
Phone: (360) 771-1155
Facebook: facebook.com/YourInsuranceGal

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