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Original Medicare or Medicare Advantage?

Which plan is the best for me?

FAQ: Products

Product

Original Medicare

Federal government

Hospital

  • deductible

  • co-insurance

Medical

  • annual deductible

  • co-insurance 20% (no limit/no cap)

  • NO networks

  • NO coverage outside the USA

  • NO prescription drug coverage

  • coordinates with supplement plan

Product

Medicare Advantage

Private Insurance company

Hospital

  • NO deductible

  • co-payments with limits

Medical

  • NO annual deductible

  • co-payments with limits

  • has networks of doctors, hospitals

  • HMO - PPO - PFFS

  • emergency coverage outside of the USA

  • prescription drug coverage included

  • supplement with an indemnity plan

Additional Benefits such as:

  • dental coverage

  • vision/eye-wear coverage

  • hearing coverage

  • gym membership

  • over the counter items

  • transportation

  • 24/7 Nurse Line

Frequently Asked Questions

Q: I am still working and my employer provides my healthcare insurance which includes prescription drugs. Do I need to enroll into a Part D prescription plan to avoid a late penalty?

A: NO, as long as your employer's prescription drug coverage is considered "credible coverage" by Medicare. Ask your Human Resource manager about credible coverage.

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Q: I am still working and my employer provides my medical insurance, do I need to enroll in Medicare Part B?

A: NO, as long as your employer provides medical coverage, you do not have to enroll into Part B. You will not be penalized enrolling at a later date as long as you keep your employer's coverage.

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Q: I receive Veterans (VA) benefits, do I need to enroll in Medicare Part B?

A: NO, and YES. The VA is a Federal program separate from Medicare. The VA is funded by Congress each year. Because the VA program is funded annually, the VA encourages all Veterans receiving benefits to enroll into Medicare Part B.

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Q: I do not take any medications, do I have to enroll into a prescription drug plan?

A: NO, but if you fail into a Part D drug plan within your initial open enrollment period and later decide to enroll, you will be charged a permanent monthly late enrollment penalty.

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Q: Do I have to enroll into Medicare Part B?

A:  NO, Part B is elective. If you fail to enroll into Part B during your initial enrollment period, and later you decide to enroll, you will be charged a permanent monthly late enrollment penalty. The penalty amount will be automatically deducted from your monthly Social Security check. Not having Medicare Part B, YOU will be responsible for 100% of your medical cost.

Q: I am covered by my spouse employers health care plan, do I need to enroll into my own Medicare plan?

A: YES, NO or Maybe. It depends upon the employers plan of benefits offered, the monthly cost for you to be covered on the plan, the annual deductible, the amount of co-payments for each service, and the company's prescription drug plan.

Q: I need help paying for my prescription drugs, are there programs that can help me?

A: YES, many of the pharmaceutical manufacturers offer programs of financial assistance with their more expensive medications. Medicare offers a special "extra help" program for qualified individuals. We will assist you in obtaining financial help with these programs.

FAQ: FAQ
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