rt When you become eligible for Medicare you have 3 options to choose from and here they are:  

 

OPTION 1 - ORIGINAL MEDICARE:
This is your red white and blue Medicare Card alone that you receive in the mail from the Federal Government when you either become eligible for Medicare when you turn 65 years old or become eligible after being on Medicare Disability for a minimum of 24 months. Original Medicare only covers 80% of your Medicare Healthcare costs leaving you paying the other 20% that medicare does not cover often referred to as “the gap” in coverage. With just your Medicare Card alone, you will have to pay the Medicare Part A (Hospital Deductible) of $1,684.00 every time you are hospitalized and also the $257 Part B Deductible one-time per year when you go to see a Medicare Doctor or Specialist. In 2025 the Part B Premium (the cost the Federal Government charges you for your Medicare Card) is $185.00 (unless you qualify for either QMB or SLMB (Medicaid). We will be happy to see if you qualify. If you have a higher income, you may have to pay more than the $185.00 per month for your Part B premium and we can tell you how much that will be if you call us. What’s most important to keep in mind is that there is no cap or limit on the 20% that the Medicare Card does not cover, which could potentially lead to some higher healthcare cost for you with just a Medicare Card alone. This is why people choose a plan offering additional coverage. You can choose either a Medicare Advantage Prescription Drug Plan (Option 3 below) or a Medicare Supplemental Plan together with a Stand-Alone Prescription Drug Plan (Option 2 below). Choosing a plan offering additional coverage can ensure Medicare healthcare benefits are covered 100%.

 

OPTION 2 - SUPPLEMENTAL PLANS - (MEDIGAP PLANS):

Supplemental plans are popular for people who do not want to be limited to a network of doctors or their doctor is not in any network. On a Supplemental plan you can see any doctor who accepts Medicare. A Supplement or MEDI-GAP plan ONLY Covers the 20% gap in coverage that Original Medicare does not cover. Some Supplemental plans do not pay the $1,684.00 Part A Deductible and NONE pay your $257.00 Part B Deductible for 2025.

Supplemental plans come with no Prescription Drug Coverage so you must buy a Stand-Alone Prescription Drug plan (PDP) to avoid a 1% late enrollment penalty. Supplemental Plans also charge a monthly premium that can and most of the time will increase yearly so it is  important to compare rates in your area annually.

Supplemental plans can raise your monthly premium at least once a year and in some states are allowed to increase your premium twice in one year so please pay attention to this. If you choose a Supplemental Plan you can expect to have a monthly plan premium for the Supplemental Plan in addition to a monthly premium for your stand alone prescription drug plan (PDP) and Medicare Part B premium of $185.00.

Within the first six months after turning 65,  Medicare eligible beneficiaries can enroll into a Supplemental Plan without having to answer any medical underwriting questions. If you switch to a Supplemental Plan after your initial open enrollment period, you could be subjected to higher premiums or possibly  denied access based on any pre-existing conditions.

 

OPTION 3 - MEDICARE ADVANTAGE PRESCRIPTION DRUG PLANS (MAPD PLANS):

These plans are popular for people who do not want to pay additional monthly plan premiums on top of their required $185.00 Medicare Part B Premium. A Medicare Advantage Prescription Drug Plan pays for the 20% gap in coverage your Original Medicare card does not cover and includes a Prescription Drug Plan with most MAPD plans having $0 or low monthly premiums.

Most Medicare Advantage Prescription Drug Plans include additional benefits such as Dental, Vision, Hearing coverage AND a Fitness Club Membership at no additional cost. These plans often have no deductible for both Medicare Part A (Hospital) and Medicare Part B (Doctor and Specialist) coverage as well as for their Tier 1, 2 and 3 prescription drugs.

NOTE: It is illegal for telemarketers to call Medicare Beneficiaries without their permission offering Medicare Advantage Plans, because these plans are subsidized by the Federal Government. Telemarketers often call from fake phone numbers and hang-up if you ask for their phone number. These telemarketers know they can face large fines and the agent they transfer your call to can lose their insurance license if caught! We advise that beneficiaries never give out their Medicare card number to a telemarketer who has called you unsolicited.

Many people on Employer Group Plans run like the wind to get on Medicare as soon as they’re eligible to avoid having a high medical deductible on their group plan, saving them thousands of dollars a year in healthcare costs!

IMPORTANT: Call us today to see if you qualify for a Low Income Subsidy (LIS) or “EXTRA HELP” which can lower your Prescription drug copays!

We will also check to see if you qualify for QMB or SLMB (Medicaid) which can pay for your monthly Part B Premium ($185.00).