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Lane
Lane, JD,CFP, MBA, CRPS
Category: Social Security
Satisfied Customers: 10090
Experience:  Law Degree, specialization in Tax Law and Corporate Law, CFP and MBA, Providing Financial, Social Security & Tax advice since 1986
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Second opinion] - I have Medicare through Advantage, M.D.,

Customer Question

Second opinion] - I have Medicare through Advantage, M.D., and was just informed I need Medigap too.
JA: These retirement benefits are supposed to help us but they can be so complicated! The Retirement Expert will help you get the most benefits propertly. Please tell me more, so we can help you best.
Customer: Is Medigap the same as Medicare Advantage plans? I really need a counselor to help me figure this out. You're right - it's so complicated, and I'm drowning in other paperwork besides!
JA: Is there anything else important you think the retirement accountant should know?
Customer: I don't know. Could you give me an example? I'm retired, and my husband is only making about $30K a year. He is not working full time. He is 68, I am 65.
Submitted: 28 days ago.
Category: Social Security
Expert:  Lane replied 28 days ago.

Hi. I can help you here.

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No, medicare advantage is an HMO like combination of Medicare part A (Hospital), Medicare Part B (Drs. and other medical insurance), and Part D (prescription drugs).

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... making it very much LIKE a medigap plan.

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The most important thing here: You CANNOT have a medigap plan if you have medicare advantage.

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So, your MAJOR CHOICE is whether to have (1) medicare advantage plan OR (2) original Medicare A, possibly B and possibly D, and then have a medigap plan with that original medicare.

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What's right for you depends on cost, what your prescriptions are, how willing you are to pay copays.

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MEDIGAP

MEDIGAP plans are private plans (again, that are stacked on top, if you will, or original medicare).These private plans cover most or all of original Medicare's out-of-pocket costs. If you select this option, you will continue to be covered by original Medicare. After Medicare has paid your claims, it will automatically forward them to your Medigap plan. The Medigap plan will then pay its portion of the bill.

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MEDIGAP plans do not cover prescription drugs. Therefore you must also purchase a stand-alone Part D plan if you want drug coverage.

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MEDICARE ADVANTAGE

Anyone on Medicare can choose to receive their Part A and Part B benefits through one of these private health plans instead of through original Medicare

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With a MEDICARE ADVANTAGE plan, you continue to pay your Part B premium as usual. You may also pay an extra premium for the plan. (And again, You are not allowed to have a Medigap and Medicare Advantage plan simultaneously).

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MEDICARE ADVANTAGE plans typically come with deductibles and co-pays. But unlike original Medicare, they have an annual out-of-pocket limit. That means that once you have paid deductibles and co-pays that add up to the annual out-of-pocket limit, the plan will pay 100 percent of your medical bills for the rest of the year.

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I'm attaching a great table that shows how Medicare Advantage and Medigap, relate to Original Medicare part A and B

Expert:  Lane replied 28 days ago.

Please let me know if you have any questions at all, before you rate me

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If this has helped, and you DON’T have other questions … I'd appreciate a positive rating (using the stars or faces on your screen, and then clicking “submit").

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Thanks!

Lane

I have a law degree, with concentration in Tax Law, Estate law & Corporate law, an MBA, specialization in financial accounting & tax, a BBA, and CFP & CRPS designations, as well - I’ve been providing financial, Social Security/Medicare, estate, corporate, non-profit, and tax advice, since 1986.

Expert:  Lane replied 26 days ago.

I’m just checking back in to see how things are going.
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Did my answer help?

If this HAS helped, and you DON’T have other questions … I'd appreciate a positive rating (using the stars or faces on your screen, and then clicking “submit")
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But again, let me know if you need more on this.
Lane

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