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Medigap and Part D Basic Benefits

Medicare’s Annual Enrollment Period (AEP) begins October 15 and ends December 7. Now is the time to review your health care needs to make sure you have the coverage you need in the coming year. Check out the MostMedicare blog for answers to your questions about AEP, and what it means to you. For plan comparison tools, reference guides and more, visit MostMedicare.com. Even if you’re happy with your current plan, it’s important that you understand the types of Medicare plans available so you can get the coverage you need, when you need it.

Every Medicare supplemental insurance plan must cover a number of basic benefits as they are all regulated. Medigap Plans A through G have one set of basic benefits, and Plans K, L, M and N have a different set of basic benefits. Take a look at the following chart for a description of those benefits.


As a Medicare recipient you have got two ways of obtaining prescription drug coverage:

  1. Medicare Part D Plan – These plans will add drug coverage your Medicare insurance plan for a monthly premium. You coverage will depend on the premium you pay and what company you chose.
  2. Medicare advantage plans (aka Part C) – Advantage plans will provide all of your Part A and B coverage and some, not all, will give you prescription drug coverage. Although, you have got to be enrolled in Original Medicare to join a Medicare advantage plan.
Along with the premium for Part D plan you have to pay a couple of other things like a yearly deductible, co-payments, coinsurance and additional costs if you reach the “doughnut hole”. Keep in mind that Your coinsurances, co-payments and your yearly deductible will count towards the coverage gap. There are a number of plans which will provide you with additional coverage during those “gaps” but they will cost more. Take advantage of the fact that Medicare Part D plans will cover all commercially-available vaccines, most seniors do not know this.
Every Part D plan will have a different “formulary”, and this post on our blog explains how it works, which is a list prescriptions drugs that it will cover, make sure you only join a plan that actually covers your medications, insurance agents fool people into buying plans that don’t address their needs just so they can get a higher commission.
Now that Medicare pays for all of your preventive health care, you may be able to save with a less expensive Medigap insurance plan. Anthem is offering guaranteed issue through Dec 1.  That means you can switch to a Medigap Plan with equal or less coverage even if you have a health problem.No one likes shopping for insurance, but you have to shop to find the right plan that fits your needs and health requirements. MostMedicare makes it easy to COMPARE and SAVE on Medigap insurance plans. Plans can vary by hundreds of dollars.
Just because some plans look alike doesn’t mean they cost the same. Prices can vary by hundreds of dollars between different insurance companies.Why pay more than you have to simply because you didn’t know there were other options. Give me a call to see whether there’s a less expensive way to get your health care.

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