Breaking Down Coverage Options
The Alphabet Plans: Medicare Supplements
Medicare Supplements are standardized plans, meaning that no matter what company you choose to buy from, the plans are all the same. An "A" plan from company x or company z will always have the same benefits.
Plans can be "age attained" or "Issue rated" which means a birthday card and a bill for a higher premium each year, or a slightly higher starting premium with much lower increases over time.
There is one exception: Physician's Mutual. PM offers a Hybrid G with a vanishing deductible. They also offer extra benefits like gym membership, thermal mammograms, lifeline screens, FULL preventive coverage and more. You can also change your plan within 24 months, no questions asked.
Medicare supplements provide up to 100% coverage in combination with Medicare Part A/B - you have to have that in order to even get one of these plans. They do not include routine things like dental, vision or hearing - but that can be achieved through a supplemental plan, with or without dental implant coverage.
Expect to pay around $98-140 per month give or take, per person to start. But remember - there are no copays, no coinsurance, no deductibles... at all. Go anywhere in the U.S., see any doctor that takes Medicare -your supplement will pay the difference completely on a Plan G. Other plans vary in coverage.
YOU ABSOLUTELY SHOULD GET A DRUG PLAN TO MEET THE FEDERAL REQUIREMENT - I have plans that start at 50 cents which meet federal requirements. If you don't, you're subject to a penalty that compounds monthly.
Medicare Advantage is Medicare Part C
It comes with (MAPD) or without (MA only) Drug Coverage.
Medicare Advantage is private insurance contracted through CMS (Centers for Medicare Services) to manage your medicare. When you get Part C you don't "lose" A/B/D - you allow Humana, Aetna, Anthem, BCBS, etc., to manage payments to Medicare.
Medicare Advantage includes some limited benefits for dental, vision and hearing, over the counter, gym, and other small ancilliary benefits. These benefits are smaller in 2024/5 due to the restructuring of Medicare Plans by CMS earlier this year.
Medicare Advantage is a copay/coinsurance system much like under-65 health plans. You have a Max Out of Pocket (MOOP), similar to a deductible - but anything you pay for medically applies to the MOOP and drops it down throughout the year. After MOOP has been met, you're covered 100%. Average MOOP is $6,500 nationwide. In Texas it can be as high as $8550. In Florida, as low as $1000. Your copays can range from $0 up to as much as $587 per day in a hospital.
Drug coverage can be included, and the max for 2025 is $2,000 and a monthly payment plan is being offered for 2025. There is no more 'donut hole" which is a good thing. But the absorption of drug costs has caused carriers like United Health Care and Humana to restructure plans taking funds from areas where members are not utilizing them, and move monies into the drug programs. So expect some lower spending accounts in 2025.
Dual eligible members who have both Medicare and Medicaid can experience comprehensive coverage with no MOOP and very little copay, if any. Expanded spending accounts will continue with Dental benefits, Vision, Hearing, over the counter spending, household spending money and even money for gasoline or transportation services. Benefits depend on the carrier, state of residence, medicare subsidy level, federal low income subsidy via Social Security and more.
You can expect to pay $0 - 150 for a Medicare Advantage plan depending on the carrier and the State.
Supplemental Insurances - Something for every budget.
Who doesn't love a good game of Jenga?
While Medicare keeps moving things around and yanking the pieces out, affordable supplemental coverages can help make up the difference:
Hospital Indemnity coverage pays fixed benefits and provides money to YOU DIRECTLY. Manhattan Life has a plan with a $10K 1st Day/Hospital benefit that is very affordable. Requires some modest underwriting, most folks are approved. Runs $35 - 100 depending on age, health and other factors.
Supplemental Dental with a Vision/Hearing Rider through NDC or Physician's Mutual coordinate coverage to fully pay your bills so you don't have anything out of pocket.
A couple can get coverage for all three (D/V/H) for about $100 a month. 70-30 plan, covers
immediately with a 12 month wait on major.
Single applicants are lower of course, about $60
Implant coverage up to $10K annual for about $100 or $120 with VSP Preferred. Here's a link for you to have a look and enroll yourself if you like: https://enrollment.ncd.com/705113
I can show you how to get 4 implants for about $3,000. No kidding.
Final expense plans can offer immediate peace of mind - Sr. Life offers over 10 different plans up to $30,000 - no death certificate required and they pay within 48 hours. Regular life insurance requires a death certificate and can take weeks to pay out... while your family struggles to make ends meet without you. Too many factors to estimate price but starting at $25 - $150.
Enhanced Accident Coverage - yes, it's Accidental Death & Dismemberment but this plan through Manhattan Life also provides payments for medical services - money paid directly to you to help get you through the hard days. About $30/mo.
Cancer Plans - lump sum benefits up to $50,000 in cash on a first diagnosis of cancer help you and your family cover travel, food, lodging, out of pocket, bills, and more, taking the pressure off you as you go through treatment and get back on your feet. Around $50/mo.