Medicare Supplement

What is a Medicare Supplement?

A Medicare supplement covers the 20% coinsurance balance that Medicare Part B does not cover

How We Can Help

  • We will educate you as to the options available
  • We will find the product that best fits your needs
  • We will review and modify your coverage as your needs change over the years
BG Banner

FAQ

What are Medicare Supplement Plans?

Medicare Supplement plans are often known as “Medigap” policies. They close the distance between the 80% that’s covered by Medicare and the 20% that isn’t. The result will be fewer or no out-of-pocket costs.

When do I Need to get a Medicare Supplement & Drug D Plan?

Medicare Supplement and Drug D Plans are needed at 65, or later if you are still working full-time and covered by your employer’s health plan. These plans assist beneficiaries enrolled in Medicare in paying for out-of-pocket costs such as copayments, copays, and prescription drugs.

What is the Most Popular Medicare Supplement Plan?

Medicare Supplement Plans are given letter names so it can be confusing. Plan G is usually the “go-to” package. It has a small deductible and then fully covers what Medicare does not.

When can I Apply for a Medicare Supplement Plan?

There is a “guaranteed issue period”. For the six months following your 65th birthday, you can get a Medicare Supplement Plan with no requirements beyond paying your premiums. By law, you can’t be excluded for any health conditions. After 6 months, insurers can require more detailed information about your health conditions such as diabetes or heart conditions, and you can expect your premiums and available plans to change accordingly.

What is the Best Way to buy Medicare Supplement Plans?

There is no one best way. You can buy directly from a trusted insurance company or go through a broker who specializes and can give you access to all the highly rated companies.  Selecting a quality company is your most important concern.

Keep in mind that Medicare rules state that all plans have to be sold in person or by phone. This allows you to ask all your questions before finalizing your decision.

What is a Medicare Drug D Plan?

The Drug D Plan covers prescriptions. Each plan that offers prescription drug coverage through Medicare Part D must give at least a standard level of coverage set by Medicare. Plans can vary the list of prescription drugs they cover (called a formulary) and how they place drugs into different “tiers” on their formularies.

How Do I Select the Best Medicare Drug D Plan?

Here are some criteria for selecting the best plan for you:

  • What are the company’s ratings?
  • Which company provides excellent customer service?
  • Which company covers the medications I take?
  • Which company has the most affordable plan?

While you need to apply for this benefit on your own, it is beneficial to work with a Medicare Drug D specialist to help guide you through this decision.

What are Tiers with Medicare Drug D Plans?

To lower costs, many plans place drugs into different  tiers on their formularies. Each plan can divide its tiers in different ways. Generally, a drug in a lower tier will cost you less than a drug in a higher tier.

Here’s an example of a Medicare drug plan’s tiers (your plan’s tiers may be different):

  • Tier 1—lowest co-payment : most generic prescription drugs
  • Tier 2—medium co-payment: preferred, brand-name prescription drugs
  • Tier 3—higher co-payment: non-preferred, brand-name prescription drugs
  • Specialty tier—highest co-payment: very high cost prescription drugs

 

 

How Do I Learn Which Drug D Plan Covers My Medications?

 

  • Go to Medicare Plan Finder at Medicare.gov which will show you which Part D drug plans are available in your area and which of those plans cover your drugs
  • Work with a Medicare Drug D specialist

 

 

Can te Prescriptions on My Drug D Plan be Changed Mid-Year?

Yes. A Medicare drug plan can make changes to its drug list during the year if it follows guidelines set by Medicare. Your plan may change its drug list because drug therapies change, new drugs are released, or new medical information becomes available.

How Will I Learn if My Prescription has been Changed on My Drug D Plan?

For changes during the year involving a drug you’re currently taking, your plan must do one of these:

  • Give you written notice at least 30 days before the date the change becomes effective.
  • At the time you request a refill, provide written notice of the change and at least one month’s supply under the same plan rules as before the change.

 

 

What Should I Do If I Still Require a Drug Changed by My Drug D Plan?

If you or your prescriber (your doctor or other health care provider who’s legally allowed to write prescriptions) believes none of the drugs on your plan’s formulary will work for your condition, you can ask for an exception.