Medicare Policy Plan Choices (Medicare Supplement Insurance) The Original Medicare Plan pays for many, but not all, health care services and supplies.  A Medigap policy is private health insurance designed to supplement the Original Medicare Plan.  This means it helps pay some of the health care costs (“gaps”) that the Original Medicare Plan doesn’t cover, like co-payments, coinsurance and deductibles.  Medigap policies are portable, guaranteed renewable and some Medigap policies cover extra benefits for an extra cost.
Enrolling in a Medigap Health Plan
  • Must be enrolled in Medicare Parts A & B.
  • Open Enrollment Period – If you enroll within 6 months of your Part B effective date, you are guaranteed coverage without having to go through underwriting.
  • After Open Enrollment Period – If you do not apply during your Open Enrollment period, you may be required to go through underwriting and may be denied coverage.

What is a Medicare Cost Plan?
  • A type of Medicare health plan available in certain areas of the country.
  • You can join anytime the plan is accepting new members.
  • You can leave anytime and return to Original Medicare.
  • If you go to a non-network provider, the services may be covered under Original Medicare and could be subject to co-insurance and deductibles.
  • You can either get your Medicare Rx (Part D) coverage from the plan or join a PDP plan.

What is a Medicare Advantage Plan?
  • Plans are offered by private companies approved by Medicare.
  • The plan will provide all of your Medicare Part A and Part B coverage.
  • If you go to a doctor, facility, or supplier that doesn’t belong to the plan, your services may not be covered.
  • You can only join a plan at certain times during the year.  In most cases, you are enrolled in a plan for a calendar year.
  • You usually get Rx (Part D) coverage through the plan.

Enrolling in a Medicare Cost or Advantage Plan
  • Must be enrolled in Medicare Parts A & B or in Part B only.*
  • You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.
  • You must permanently reside within the service area.
  • You must not have End-Stage Renal Disease (ESRD).**
*If you enrolled in Part B only, you will have no coverage for Part A services. **Some exceptions apply.