Medicare Plans

Most Americans are eligible to receive Original Medicare benefits (Parts A and B) at age 65 — or earlier if they have a qualifying disability. Once enrolled, you must pay a Part B monthly premium to maintain eligibility. There are no additional requirements.

However, most people choose to enhance their Medicare coverage.

An FTJ Senior Insurance specialist can help you understand the options available to expand Medicare coverage or fill in coverage gaps. Your specialist can provide comparisions of the cost and benefits of multiple plans, answer any questions you have, and guide you in making a choice of plans that meet your health care needs. Complete the form below to begin your consultation.

Plans that expand Original Medicare coverage fall into the following categories:
 

1.  Medicare Advantage

Medicare Advantage plans, also known as Medicare Part C, cover all the same services as Original Medicare (Parts A and B), plus additional benefits such as:

• Prescription drug coverage. Most Advantage plans include a Medicare Part D prescription drug benefit
• Dental, vision and hearing benefits, which help cover the cost of routine care, such as dental exams and procedures; vision exams, eyeglasses, and contact lenses; and hearing devices.
• Wellness programs, that provide access to fitness centers, health education, and other wellness benefits.
• Transportation assistance to medical appointments.
• Special needs plans designed for individuals with chronic conditions or complex healthcare .

Medicare Advantage plans are offered by private insurance companies, and all care is coordinated through these plans. In most cases, there is a monthly premium for the Advantage plan that must be paid in addition to Medicare Part B monthly premiums.

2.  Medicare Supplement Plans

Medicare Supplement plans, also called Medigap plans, help cover out-of-pocket costs associated with Original Medicare (Parts A and B), including deductibles, copays, and coinsurance. Some plans also provide benefits for services not covered by Original Medicare, such as emergency medical care when traveling outside the U.S.

Medigap plans generally do not provide vision, dental, hearing, or prescription drug benefits. However, all Medigap plans charge monthly premiums that must be paid in addition to Medicare Part B monthly premiums.

3.  Prescription Drug Plans

Prescription Drug plans, also referred to as Medicare Part D, are voluntary plans that help pay for brand-name and generic prescription drug not covered by Original Medicare (Part A and B). Generally, these are prescriptions dispensed by an outpatient retail pharmacy.

The cost of Prescription Drug plans vary based on their formulary, which is a list of drugs the plan covers, and the structure of the the plan's deductibles, copays, and coinsurance. In all cases, however, Prescription Drug plans cap out-of-pocket costs for covered drugs at $2,000 per year.

Prescription drug plans can significantly reduce your out-of-pocket costs compared to paying for medications at full price. However, it's important to choose a plan that covers the drugs you use, while excluding costly drugs you do not use. Since formularies can change every year, you have to re-evaluate your plan every year.

As with Medicare Advantage and Medigap plans, monthly premiums for a Prescription Drug plan must be paid in addition to the Medicare Part B monthly premiums.

4.  Individual Policies

If you're not enrolled in a Medicare Advantage plan, you may wish to purchase an individual policy for dental, vision, or other type of care. FTJ Senior Insurance offers a variety of individual policies from which choose, and your Medicare specialist can help you find coverage that fits your particular needs.