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Understanding DIFFERENCES in Medicare Plans is EXTREMELY IMPORTANT!

ADVANTAGE plans ARE NOT THE SAME as ORIGINAL MEDICARE - ASK QUESTIONS before purchasing your plan! 

 

PART A IS "ORIGINAL MEDICARE"

In general, Part A covers -

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PART B IS "ORIGINAL MEDICARE"

*PART B - NEW INSULIN BENEFIT!  Starting July 1, 2023, if you use an insulin pump that's covered under Part B's durable medical equipment benefit, or you get your covered insulin through a Medicare Advantage Plan, your cost for a month's supply of Part B-covered insulin for your pump can't be more than $35. The Part B deductible won't apply. If you get a 3-month supply of Part B-covered insulin, your costs can't be more than $35 for each month's supply. This means you'll generally pay no more than $105 for a 3-month supply of covered insulin. If you have Part B and Medicare Supplement Insurance (Medigap) that pays your Part B coinsurance, you plan should cover the $35 (or less) cost for insulin.

Part B covers 2 types of services

Part B covers things like:

Email: Susan@Sumrall.Agency                         Or Call: 575-313-2577

 

 

ORIGINAL MEDICARE Part A & Part B Supplemental Medicare (Medigap) Options

Medigap Plans are available for purchase to add coverage to what Part A or Part B will not cover

Medigap IS NOT Advantage. It is not possible to purchased Original Medicare and Advantage at the same time.

Medigap Plans are named C, F, G, K, L, M & N 

Email: Susan@Sumrall.Agency                        Or Call: 575-313-2577


ORIGINAL MEDICARE "DEDUCTIBLE" IS DETERMINED BY THE UNITED STATES GOVERNMENT on an annual basis
The annual deductible for all Medicare Part B beneficiaries is $226 in 2023

Plan A -
Hospital Coverage
Plan B -
Office vistits and non-hospital visits (x-rays, tests, etc). Meaning that some hospital procedures may be included in Part B and not Part A
Plan C -
is NOT ORIGINAL MEDICARE. Plan C is also ONLY available for people who because eligible on, or before, January 1, 2020
Plan D -
ALL pharaceutical plans that ARE SUPPLEMENTAL to ORIGINAL MEDICARE
Plan F -
IS NOT available for people who because eligible on, or before, January 1, 2020. Plan F covers everything - including coverage for annual deductible.
              HOWEVER, if you became eligible before 2020, you may be able to enroll in Plans F or C as long as they are available in your area.
Plan G - Pays 100% of EVERYTHING not covered by Plans A&B AFTER the annual deductible is met/paid
Plans F and G offer a HIGH DEDUCTIBLE option of $2700 per year (the deductible is set by the US Government on an annual basis). Once deductible is paid, 100% of covered expenses are paid
Plans F and G are the ONLY Medigap Plans that pay Excess Charges (Charges "allowed" by Original Medicare, but OVER acceptable)
Plan K - has an out-of-pocket yearly limit of $6940 (this limit is set by the US Goverment on an annual basis). After the $6,940 is paid, insurance pays everything at 100% for the calendar year
Plan L - has an out-of-pocket yearly limit of $3,470 (this limit is set by the US Goverment on an annual basis). After the $3,470 is paid, insurance pays everything at 100% for the calendar year
Plan M -
Deducibles and ALL excess charges are the responsibility of the patient
Plan N- Pays 100% of Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 copayment for emergency room visits that are so not result in an inpatient admission


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Cost of Medigap plans vary, depending on the company that is selling the plans AND depending on what area the patient lives in.
If a person moves, they have to "re-do" Medigap AND Advantage coverage to "meet" the new location.
Medicare guides and availabilities. Massachusetts, Minnesota and Wisconsin have different Medigap standards

There are 9 standardized benefits included in consideration of purchase of Medigap Plans: 

EMAIL: Susan@Sumrall.Agency                        OR CALL: 575-313-2577

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