Available Medicare Plans

Medicare Supplement (Medigap)

• You pay a monthly fee in addition to the Part B premium, and the private plan covers the costs in Original Medicare.

• There are 8 plans (each has its own letter) standardized by the Federal Government, but offered by private insurance companies.*

• The monthly fee can generally range from $50 - 350, depending on the plan type and your home state.

• No drug coverage, or dental, hearing and vision benefits.

• No medical underwriting up to 6 months after enrolling in Part B at age 65 or older

• Guaranteed renewable

• Coverage nationwide; no provider network

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Medicare Advantage (Part C)

 

Medicare Advantage

• All the benefits of Part A and Part B

• You’re still in the Medicare program, but plans are offered by private companies

• Most plans include prescription drugs

• Many plans offer additional benefits:

  • Routine dental

  • Routine eye exams and eyeglasses

  • Hearing tests & aids

  • Wellness programs

 

Costs

• Continue to pay the Part B plan premium

• Many plans are $0 premium

• But you have out-of-pocket co-pays and co-insurance when you use services

• Typically have annual out-of-pocket maximum

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Other Factors

• You may need a referral to see a specialist

• Coordinated care support with provider network

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Prescription Drug Coverage (Part D)

 

Plans cover:

• Most common medications

• Specific brand name & generic drugs according to the plan’s formulary (drug list)

• Vaccines not covered by Part B

 

How it works

• You pay a monthly premium. The average premium is ~$33.

• You have a co-pay for each medication, based on its tier. There are 4 or 5 tiers, from lowest to highest priced.

• You may also have a deductible

• You may have to use a specific pharmacy network

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You can get Part D via a stand-alone Part D plan OR via a Medicare Advantage plan that includes prescription drug coverage (MAPD)

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Dual Special Needs Plans (D-SNP) 

• You qualify for Medicaid (AHCCCS) and Medicare

• You are entitled to additional benefits not available to other medicare beneficiaries including additional Dental, Vision, and Hearing services, as well as a monthly grocery allowance!

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Chronic Special Needs Plans (C-SNP)

• Additional help if you are living with a chronic condition such as diabetes or heart disease

• You or your loved one is enrolled in the state Long Term Care Program (ALTCS)

• You or your loved one is living in a nursing home or needs additional care

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Dental Plans

• Stand alone dental plan options are available for you in the event (1) you opt for a Medigap Plan that does not include dental or (2) Do not qualify for Dental Coverage