Part B: Medical Insurance – What You Need to Know

Medicare Part B helps cover doctor visits, outpatient care, and other medical services. Here are the key things to keep in mind:

• It has an annual deductible, which changes each year. Thankfully, it’s usually much more affordable than the deductibles you had with your pre-Medicare health insurance.

• There’s a 20% cost share after the deductible. So, if your medical bills hit $100,000, you could be on the hook for $20,000 if you only have Parts A & B.

But don’t stress—we have options to help you avoid taking on that kind of risk.

Part B does come with a monthly premium, and yes, everyone has to pay it. There’s a standard amount, but if your income is above a certain threshold, you'll pay an additional amount called IRMAA (Income-Related Monthly Adjustment Amount).

Remember: Parts A & B—together known as Original Medicare—were never designed to cover 100% of your medical costs. That’s why we work with you to fill in the gaps.

Part C: Medicare Advantage – What You Need to Know

Medicare Part C, also known as Medicare Advantage, is an all-in-one alternative to Original Medicare. These plans are offered by private insurance companies approved by Medicare and typically include Part A, Part B, and often Part D (prescription drug coverage).

Here’s what you should know:

• Premiums vary by location. In many areas, especially where these plans are popular, premiums can be as low as $0 per month. Yes—zero.

• Some plans have no deductible, but you’ll have copays and coinsurance for various services, depending on the plan.

• Drug coverage is usually included at no additional premium, and most plans throw in extra benefits like limited dental, vision, hearing, or even gym memberships.

Just keep in mind:

• You must use in-network providers for your plan to work as intended.

• There is an out-of-pocket maximum, which means if you have a high-cost year, your medical expenses will be capped, unlike Original Medicare.

Important Note: Medicare Advantage plans include coverage for skilled nursing facilities, but it only lasts up to 100 days. After that, you’re on your own unless you’ve made additional plans. We’ll help you figure out what your options are for care beyond day 100.

Just because a cousin in another state loves their Medicare Advantage plan doesn’t mean it will work the same for you. These plans vary greatly by county, so let’s look at what’s available in your area and compare options together.

Part D: Prescription Drug Coverage – What You Need to Know

This one’s easy to remember: “D” stands for drugs.

Medicare Part D is the part of your plan that helps cover prescription medications you pick up at the pharmacy.

Here’s why it matters:

• You’ll want to make sure all your medications are covered by the plan you choose, because if they’re not, you could end up paying full price out of pocket.

• There’s a cap on what you’ll pay for covered medications—but that only applies to drugs that are included in your plan.

The good news?
We’ll review your medications every single year during open enrollment to make sure you're still on the right plan. Part D plans change annually, and we don’t want you facing any surprises at the pharmacy counter.

A couple more things to keep in mind:

• If you enroll in a Medicare Advantage plan (Part C), it will most likely include Part D coverage at no extra premium.

• If you choose a Medicare Supplement plan, you’ll need to add a stand-alone Part D plan, which will come with its own monthly premium.

Medicare Supplement (Medigap) – What You Need to Know

If you decide not to go with a Medicare Advantage (Part C) plan, your other option is to pair Original Medicare with a Medicare Supplement plan, often called Medigap.

Here’s what you should know:

• These plans are offered by private insurance companies and come with a monthly premium.

• Your premium is based on factors like your age, location, and the specific plan letter you choose.

Medicare Supplement plans are labeled with letters, like Plan G and Plan N, which are two of the most popular options.
Here’s the key point:
Plan G is Plan G is Plan G—no matter the company.
The same goes for Plan N. The coverage is identical, but premiums and customer service can vary.

Common Mistake Alert:
Many people just pick the company with the lowest price, but some carriers are known for starting cheap and then raising rates significantly after a few years.
To be clear: All plans will go up over time, but we help you choose a company with a strong track record and manageable rate increases.

With a Supplement plan:

• You’ll have a small annual deductible, and after that, your medical costs will be minimal or fully covered, depending on the plan.

• There are no networks, which means you can go to any doctor or hospital in the U.S. that accepts Medicare.

One important note: Medicare Supplement plans do not include drug coverage, so you’ll need to add a stand-alone Part D plan, which will have its own monthly premium.