Medicare Options
Medicare Advantage
Medicare Advantage is also known as Medicare Part C. The best way to think of a Medicare Advantage plan is as an all-in-one type of plan. These plans become a primary insurance that administer your Medicare benefits through a private insurance company. They include all of Medicare Part A, all of Medicare Part B and typically include your Part D drug coverage. A key factor when compared to Original Medicare is that Advantage plans provide you with a maximum out of pocket limit (MOOP) that limits what your medical/hospital out of pocket costs can be in a calendar year. In addition, they usually include extra benefits beyond what Medicare covers.
If you have Medicare AND Medicaid (aka Forward Health or BadgerCare) then there is a special type of Medicare Advantage plan you may be eligible for called a Dual Special Needs Plan. This type of plan is designed specifically for someone with both programs and gives you loads of extra benefits .
Click here to learn more about Dual-SNPs.
If you have a chronic condition, such as diabetes or a cardiovascular disorder, then you may qualify for a Chronic Special Needs Plan. This is a Medicare Advantage plan designed specifically for someone with a qualifying chronic disease and may offer lower costs for medical care and certain prescription drugs associated with your chronic illness.
Click here to learn more about Chronic-SNPs.
Medicare Supplement
Medicare Supplements are also known as Medigap policies – due to their purpose of picking up the “gaps” in costs that Medicare doesn’t cover (such as the remaining 20%). The best way to think of a supplement plan is “set it and forget it”. They typically come with higher monthly premiums but have little or no out of pocket costs when going to the hospital or doctor. Supplements are secondary to Original Medicare and will pick up part or all of the costs that Medicare doesn’t cover for approved services. Since they are a secondary insurance, they will only cover what Medicare covers – meaning they don’t provide coverage for Part D prescription drugs, routine dental, routine vision, routine hearing, etc. So if you need coverage for those items you have to purchase those policies in addition to the supplement plan.
Part D (Prescription Drug Coverage)
Medicare Part D is not part of Original Medicare and is only offered through private insurance companies. You can get a Part D plan by itself (usually to go with your Medicare Supplement) or you can get Part D included in a Medicare Advantage plan. The monthly premiums for these plans vary widely and so do the copays you pay for your drugs. In addition, each plan may have a different formulary (list of covered drugs). This is often one of the biggest factors in determining what plan, or type of plan, will save you the most money. But what if you don’t take any prescriptions? First, that’s great! However, Medicare still requires you to have Medicare Part D or “creditable drug coverage” as good as Medicare’s (such as VA benefits). If you go greater than 62 days without creditable drug coverage then Medicare will assess a late enrollment penalty that you pay every month for the rest of your life whenever you do add Part D.
Medicare Advantage
Medicare Advantage is also known as Medicare Part C. The best way to think of a Medicare Advantage plan is as an all-in-one type of plan. These plans become a primary insurance that administer your Medicare benefits through a private insurance company. They include all of Medicare Part A, all of Medicare Part B and typically include your Part D drug coverage. A key factor when compared to Original Medicare is that Advantage plans provide you with a maximum out of pocket limit (MOOP) that limits what your medical/hospital out of pocket costs can be in a calendar year. In addition, they usually include extra benefits beyond what Medicare covers.
If you have Medicare AND Medicaid (aka Forward Health or BadgerCare) then there is a special type of Medicare Advantage plan you may be eligible for called a Dual Special Needs Plan. This type of plan is designed specifically for someone with both programs and gives you loads of extra benefits .
Click here to learn more about Dual-SNPs.
If you have a chronic condition, such as diabetes or a cardiovascular disorder, then you may qualify for a Chronic Special Needs Plan. This is a Medicare Advantage plan designed specifically for someone with a qualifying chronic disease and may offer lower costs for medical care and certain prescription drugs associated with your chronic illness.
Click here to learn more about Chronic-SNPs.
Medicare Supplement
Medicare Supplements are also known as Medigap policies – due to their purpose of picking up the “gaps” in costs that Medicare doesn’t cover (such as the remaining 20%). The best way to think of a supplement plan is “set it and forget it”. They typically come with higher monthly premiums but have little or no out of pocket costs when going to the hospital or doctor. Supplements are secondary to Original Medicare and will pick up part or all of the costs that Medicare doesn’t cover for approved services. Since they are a secondary insurance, they will only cover what Medicare covers – meaning they don’t provide coverage for Part D prescription drugs, routine dental, routine vision, routine hearing, etc. So if you need coverage for those items you have to purchase those policies in addition to the supplement plan.
Part D (Prescription Drug Coverage)
Medicare Part D is not part of Original Medicare and is only offered through private insurance companies. You can get a Part D plan by itself (usually to go with your Medicare Supplement) or you can get Part D included in a Medicare Advantage plan. The monthly premiums for these plans vary widely and so do the copays you pay for your drugs. In addition, each plan may have a different formulary (list of covered drugs). This is often one of the biggest factors in determining what plan, or type of plan, will save you the most money. But what if you don’t take any prescriptions? First, that’s great! However, Medicare still requires you to have Medicare Part D or “creditable drug coverage” as good as Medicare’s (such as VA benefits). If you go greater than 62 days without creditable drug coverage then Medicare will assess a late enrollment penalty that you pay every month for the rest of your life whenever you do add Part D.
Hassle-Free
We can help you review your needs several different ways: face-to-face, by phone and email. Many people prefer the in-person feel and we travel right to you so you can be in the comfort of your own home. Others are more comfortable utilizing technology to communicate and make their decisions. Whatever your preference, we’re here to make it easy for you!
Knowledgeable
Patch Adams Medicare Solutions is aligned with some of the largest agencies in the country and partnered with several in Wisconsin. We have a lot of information to share and our partners ensure we have all of the support we need so that we can focus on helping you!
Honest
Our goal is to provide high quality service by doing what’s right. The insurance industry can be complex, which is why the primary purpose of our business is to educate others on how it all works. We will help you review your current coverage and what your options are. If you’re already in the plan that’s best for you, we will tell you. It’s as simple as that – doing what’s right.
Here is why
More reasons to choose us
Here is why
More reasons to choose us
Hassle-Free
We can help you review your needs several different ways: face-to-face, by phone and email. Many people prefer the in-person feel and we travel right to you so you can be in the comfort of your own home. Others are more comfortable utilizing technology to communicate and make their decisions. Whatever your preference, we’re here to make it easy for you!
Knowledgeable
Patch Adams Medicare Solutions is aligned with some of the largest agencies in the country and partnered with several in Wisconsin. We have a lot of information to share and our partners ensure we have all of the support we need so that we can focus on helping you!
Honest
Our goal is to provide high quality service by doing what’s right. The insurance industry can be complex, which is why the primary purpose of our business is to educate others on how it all works. We will help you review your current coverage and what your options are. If you’re already in the plan that’s best for you, we will tell you. It’s as simple as that – doing what’s right.