03/31/2026
As I have been getting this question a lot lately...Just a quick post about the different options for Medicare recipients.
Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). Most clients pay a monthly premium for Part B (2026 is $203), along with deductibles, coinsurance and possible "excess charges" which can lead to higher out-of-pocket expenses without supplemental (Medigap) coverage.
Medicare Supplement (Medigap) complements Original Medicare by covering out-of-pocket costs like copayments, coinsurance, deductibles and excess charges. Clients pay a monthly premium but may see any doctor nationwide who accepts Medicare without network restrictions. The clients who choose this option have the flexibility to see any doctor nationwide who accepts Original Medicare. Medigap plans do not cover RX medications (stand alone PDP plans are required for medication help as well as to avoid the LEP (late entrant penalty) Nor do they cover additional services like dental, vision, or hearing; separate plans can be added to offset costs. .Some supplement plans do have SilverSneakers benefits. This option works best for clients who want to minimize out-of-pocket costs, and value flexibility in choosing providers.
Medicare Advantage plans are offered by private insurance companies and have benefits under Medicare A & B rolled into the plan. Most cover Part D (prescription drugs), many have a monthly $0 premium with copays for usage along the way. They DO come with network restrictions. While MAPD plans may have lower premiums, they may have higher initial out-of-pocket costs than Original Medicare plus Medigap. Many MAPD plans offer extra benefits, such as dental, vision, hearing, and wellness programs, but clients typically need to use a network of doctors and hospitals.
This option is ideal for clients looking for lower up front costs
"pay as you go", extra benefits, and coordinated care within a network.
AND, of course, if you have any questions, please give us a call!