Individuals on Medicare

Medicare Supplement

Adrian, Tecumseh, Lenawee County,  State of Michigan Medicare Health Plan Options

Whether you’re new to Medicare, getting ready to sign up, or you’ve had Medicare, we make selecting the right supplemental insurance as easy as possible. We give you access to the most affordable plans in your area from the nation’s most recognized insurance carriers, all in one place. We want to make sure that you find the best plan and carrier.

What is a Medigap Policy? (i.e. Medicare Supplement)

A Medigap policy is health insurance sold by private insurance companies to fill “gaps” in Original Medicare coverage. Medigap policies help pay your share (co-insurance, co-payments, or deductibles) of the costs of Medicare-covered services. When you are in Original Medicare and have a Medigap policy, then Medicare and your Medigap policy will pay their shares of covered health care costs. Insurance companies can only sell you a “standardized” Medigap policy. These Medigap policies must all have specific benefits.

Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium $164.90 in 2023.  In some cases, your monthly  premium may be adjusted based on your income.  One such case might be an income-related monthly adjustment amount. (IRMAA).   You will also have to pay a premium to the Medigap insurance company. In Michigan you may be able to choose from up to 10 different standardized Medigap policies (Medigap Plans A through N) Medigap policies must follow Federal and State laws as these laws protect you.

Medigap Plans C and F have been phased out.  If you were not eligible for Medicare until January 1, 2020 or later, you won’t be able to purchase Plan C or Plan F.  If you’re eligible for Medicare before January 1, 2020, you might be able to purchase Plan C or Plan F

It’s important to compare Medigap policies because the benefits in any Medigap Plan A through N are the same for any insurance company, but the costs can vary, and may go up as you get older. Each insurance company decides which Medigap policies it wants to sell and the price for each plan (with state review and approval).

What are Medicare Advantage Plans?

Medicare Advantage Plans are health plan options that are approved by Medicare and run by private companies. They are part of the Medicare Program, and sometimes called “Part C.” When you join a Medicare Advantage Plan, you are still in Medicare. Some of the premiums or the costs of services (co-pays) can be lower in a Medicare Advantage Plan than they are in the Original Medicare Plan or the Original Medicare Plan with a Medigap policy. Medicare Advantage Plans provide all of your Part A (hospital) and Part B (medical) coverage and must cover medically-necessary services. They generally offer extra benefits, and many include Part D drug coverage. These plans often have networks, which means you have to see doctors who belong to the plan or go to certain hospitals to get covered services. In many cases, your costs for services can be lower than in the Original Medicare Plan. Some of these plans coordinate your care, using networks and referrals, more than others. This can help manage your overall care and can also result in savings to you.

Medicare pays an amount of money for your care every month to these private health plans, whether or not you use services. Medicare Advantage Plans also include options that provide specialized care for  people who require more  health care services. Even if you are out of the service area of the plan, you are still covered for emergency or urgently needed care.

We can help you analyze your needs and recommend appropriate solutions.

What Is Medicare Part D?Part D

Medicare Part D prescription drug coverage, often referred to as Part D, is provided and coordinated by Medicare-approved private insurance companies. Any beneficiary who is eligible for Original Medicare, Part A and/or Part B, and permanently resides in the service area of a Medicare Prescription Drug Plan, can sign-up for Medicare Part D. Medicare Part D coverage is optional, but if you don’t enroll in Part D as soon as you’re eligible, you might pay a late-enrollment penalty if you enroll later.

You can get Medicare Part D coverage through a stand-alone Medicare Prescription Drug Plan if you’re enrolled in Original Medicare. If you’re enrolled in a Medicare Advantage plan, you can get this coverage through a plan that includes drug benefits, also known as a Medicare Advantage Prescription Drug Plan. Different insurers offer different types of plans, so your monthly plan premium and out-of-pocket expenses for prescription drugs will vary from plan to plan.

Every Medicare Prescription Drug Plan has a formulary which is simply  a list of covered drugs and these formularies vary among plans. The formulary may change at any time. You will receive notice from your plan when necessary.