Medicare Advantage & Part D

Medicare Advantage (Part C) plans are offered by private insurance companies approved by Medicare. They provide all the benefits of Original Medicare (Part A and Part B), and often include extra coverage like prescription drugs (Part D), dental, vision, and hearing.  

Medicare Part D plans add prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. Like Medicare Advantage plans, they are offered by private insurance companies approved by Medicare.

Benefits of Medicare Advantage Plans

Medicare Advantage plans offer a number of benefits that Original Medicare does not, such as:

  • Lower costs: Medicare Advantage plans often have lower premiums than Original Medicare.  

  • Extra benefits: Medicare Advantage plans may offer extra benefits such as dental, vision, and hearing coverage.  

  • Prescription drug coverage: Most Medicare Advantage plans include prescription drug coverage.  

  • Out-of-pocket maximum: Medicare Advantage plans have an annual out-of-pocket maximum, which limits the amount you have to pay for covered services.  

  • Comprehensive Coverage: Medicare Advantage plans can be particularly beneficial for individuals with specific health needs or those seeking more comprehensive coverage than Original Medicare provides. They offer a convenient, all-in-one alternative to managing multiple plans.  

Costs of Medicare Advantage Plans

The costs of Medicare Advantage plans vary depending on the plan you choose. However, in general, you will pay a monthly premium, and you may also have to pay deductibles, copays, and coinsurance. While Medicare Advantage plans may have lower premiums, it's important to consider potential out-of-pocket costs for services. These costs can vary depending on the plan and the specific services you need. You should also compare the costs of Medicare Advantage plans with the costs of Original Medicare with a Medigap policy to help potential clients make informed decisions.  

Benefits of Medicare Part D Plans

Medicare Part D plans provide prescription drug coverage. If you're enrolled in Original Medicare, you can enroll in a standalone Part D plan. Or, you can get prescription drug coverage as part of a Medicare Advantage plan.

Medicare Part D plans help lower the cost of prescription drugs. They also offer a number of other benefits, such as:

  • Cost protection: Part D plans help protect against high-cost prescription drugs.  

  • Catastrophic coverage: Part D plans have a catastrophic coverage phase, which limits the amount you have to pay for covered drugs.  

  • Extra Help: The Extra Help program helps people with limited income and resources pay for their Part D costs.  

Costs of Medicare Part D Plans

The costs of Medicare Part D plans vary depending on the plan you choose. However, in general, you will pay a monthly premium, and you may also have to pay an annual deductible, copays, and coinsurance.  

Eligibility for Medicare Advantage and Part D Plans

To be eligible for a Medicare Advantage or Part D plan, you must meet the following requirements:

  • Medicare Enrollment: Be entitled to Medicare Part A and enrolled in Medicare Part B (for Medicare Advantage) or have Medicare Part A or Part B (for Part D).  

  • Residency: Live in the plan's service area.  

  • Citizenship/Lawful Presence: Be a U.S. citizen or lawfully present in the U.S.