Medicare Overview

Simplifying Insurance for Individuals, Families, Business Owners, & their Loved Ones across the US

While Medicare provides extensive coverage for many healthcare needs, it doesn’t cover everything. Beneficiaries are often responsible for various co-payments and deductibles, which can accumulate to significant amounts. Without additional coverage, these out-of-pocket expenses can become burdensome.

To address these gaps, many individuals turn to private insurance options. There are two primary types of private insurance for Medicare beneficiaries: Medicare Advantage plans and Medicare Supplement plans. Although both offer valuable benefits, they have distinct differences that are important to understand when choosing the best option for your needs.

Medicare Advantage vs Medicare Supplement Program Designs

Medicare Advantage and Medicare Supplement plans each offer unique ways to enhance your Medicare coverage.

With a Medicare Supplement (Medigap) plan, you remain enrolled in Original Medicare. Medicare handles the majority of your healthcare costs, while the Supplement plan helps cover additional out-of-pocket expenses such as co-payments and deductibles.

On the other hand, when you choose a Medicare Advantage plan, you switch to a private health insurance plan that takes over all your Medicare coverage. These plans must provide at least the same level of coverage as Original Medicare, except for hospice care, which remains covered by Medicare. Although both options aim to provide comprehensive coverage, they operate through different structures and setups.

Frequently Asked Questions

What is Medicare and who can get it?

Medicare is primarily used by individuals aged 65 and older, though some younger people may also qualify, including those with disabilities, permanent kidney failure, or amyotrophic lateral sclerosis (Lou Gehrig’s disease). While Medicare helps cover various healthcare costs, it does not fully cover all medical expenses or most long-term care costs.

Yes, you can adjust your Medicare coverage during specific enrollment periods, including the Annual Enrollment Period (AEP) and the Medicare Advantage Open Enrollment Period (MA OEP). Outside of these times, you may qualify for a Special Enrollment Period (SEP) if you experience certain life events, such as moving, losing other coverage, or becoming eligible for Medicaid.

 

Medicare is divided into four parts:

  • Part A: Hospital Insurance
  • Part B: Medical Insurance
  • Part C: Medicare Advantage Plans
  • Part D: Prescription Drug Coverage

For more information about Medicare, you can visit the official website at www.medicare.gov, contact the Medicare hotline at 1-800-MEDICARE (1-800-633-4227).

We’re here to help you explore the options that best fit your needs. Contact us today for a free consultation, and let us guide you through your choices. Call us at 417-218-0088 or click “Call Now” below to get started!