Medicare
Medicare is health coverage provided by federal government. Medicare has 4 parts. The part are A, B, C, & D. Parts A & B are original medicare or better known as (straight medicare). Part C & D are offered through private insurance companies not the federal Government. Part C is known as Medicare Advantage. And part D covers the prescription drug portion of a Medicare beneficiaries health care.
Medicare Supplement
Medicare Supplement Insurance works with original Medicare Part A & Part B and depending on the plan pays a portion or all of what Medicare does not pay. This includes deductibles and coinsurances. Medicare supplement are standardized by Medicare.
Medicare Advantage
Medicare Advantage Plans better known as Medicare Part C help manage the cost of health provided through Medicare. Medicare Advantage can be a very attractive choice when trying to manage the cost left behind by original Medicare. Medicare Advantage offers beneficiaries low to no premium and most plans include Part D drug coverage. Medicare Advantage Plans work similar to major medical plans most people may have had through work. Medicare Advantage Plans come HMO, PPO, Private Fee for service, or Special Needs Plans (SNP).
Part D
Part D can be purchased as a stand-alone our accessed through a Medicare Advantage Plan (Part C). Part D drug coverage helps with the cost of prescription drugs for Medicare beneficiaries. Part D Drug Plans work on a tier system. Drugs are placed on tiers based on the type (Brand) (Generic), or by the cost of the drug. Part D usually has anywhere from 4 tiers to 6 tiers. The lower the tiers the lower the cost to the plan member. Part D Drug Coverage has four Phase. The deductible phase is the first, (the deductible for 2018 is $405). Some plans may not have this phase. The second is Initial Coverage phase. During this phase, the member pays their cost share defined by the plan they have. The third phase is the Coverage Gap phase. Phase 3 is entered once the member total drugs cost reach $3,750 within a calendar year. The member will pay 35% of the cost for brand name drugs, and 44% of the cost for generics for 2018. The fourth phase is the Catastrophic phase. During this phase the member has reached 5,000 totals out of pocket (TOOP) for the calendar year and will pay $8.35 for brand name or $3.35 for generic drugs, or 5% of your medication’s cost, whichever is greater-for the remainder of the calendar year. Most people taking a few maintenance drugs, or no drugs usually stay in the first two phases. Others who may take a lot of drugs or very expensive drugs get to Phase 3 and even phase 4. Some people qualify for low income subsidy (LIS) also known as Extra Help which keeps them from experiencing the coverage gap and catastrophic phase. LIS recipients are excluded from coverage gap cost. This program is administered by social security and is income based to qualify.