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Close the Medicare Coverage Gap

Since 1966, the government’s Medicare program, also known as Basic Medicare, has helped millions of Americans attain health care. It includes coverage at the hospital (known as Medicare Part A) and at the doctor’s office (or Medicare Part B).

Unfortunately, Basic Medicare can become expensive. When going to the doctor, you must pay for 20% of your care out-of-pocket -- and there is no maximum cap on these fees, meaning the more care you need, the more you pay. Basic Medicare also provides no prescription drug coverage -- meaning you do not get any help paying for medication at the pharmacy. Add to the fact that there is no dental, vision, and long term care, Basic Medicare can have gaps in coverage may not be enough.

Fortunately, the government has authorized certain health insurance companies to offer Private Medicare plans that help fill-in these gaps in Basic Medicare coverage. Private Medicare plans are a great way to lower your out-of-pocket costs and get the benefits that you deserve.

And Medicare2017.org has access to the top Medicare Insurance providers offering Private Medicare options -- including Medicare Advantage, Part D, and Medigap plans -- all with one simple to use website. Making sense of your enrollment options has never been easier with Medicare2017.org.

Learn more about Medicare2017.org and some common Medicare questions here.

To start comparing your options, just enter your zip code to begin. You can also call () - to speak to a licensed sales agent.

Plan Types
  • Basic Medicare
  • MediGap
  • Medicare Advantage
  • Prescription Drug Plans
  • What Is It? Basic Medicare (Parts A & B) is the health coverage provided by the government. Part A is for inpatient or hospital coverage and Part B is for outpatient or doctor's office coverage.
  • Who Is Eligible? To be eligible, you must be turning or have already turned 65 years old, and have paid federal taxes for at least 10 of your working years. Those under 65 may qualify if they have a disability.
  • When Can I Enroll? You can enroll in Basic Medicare during the Initial Enrollment Period. The Initial Enrollment Period is the 7 months surrounding your 65th birthday (3 months before, the month of, and 3 months after your birthday).

    If you miss the Initial Enrollment Period, you can sign up during the General Enrollment Period, which is between January 1 and March 31. Unfortunately, you have to wait until July 1 for your coverage to begin. Additionally, you could pay higher premiums when you purchase supplemental coverage from a private insurer.

    If you or your spouse are currently over 65 and have health coverage through your employer, you can get Basic Medicare during the Special Enrollment Period. The Special Enrollment Period will begin once your employer-based coverage expires.

  • How Much Does It Cost? For Part A, or hospital care, most pay $0 if they have paid Medicare taxes for at least 10 years. If you did not pay taxes, you could pay as much as $413 a month. When using hospital-related services, you will need to pay a deductible of $1,316 before the plan starts paying for the rest of the costs. If you are hospitalized multiple times a year, you may have to pay the deductible for each hospitalization. Also, if you are in the hospital for more than 60 days, you could face a co-pay of $329-$658 or more per day.

    For Part B, or doctor's office care, most pay about $134 per month. The deductible is $183 each year. When using doctor's-office-related services, you will have to pay 20% of costs out-of-pocket.

  • How to Enroll? You can apply online at https://www.ssa.gov/medicare/, on the phone at 1-800-772-1213, or visit your local Social Security office. You can learn more at medicare.gov.
  • Important: Basic Medicare only pays for a fraction of your health care. Many, especially those with medical conditions, can be financially burdened by out-of-pocket costs, including deductibles and coinsurance fees. Basic Medicare also does not provide outpatient prescription drug coverage. It is recommended you purchase a Medigap or Medicare Advantage plan, along with a Medicare Prescription Drug Plan, to protect you from mounting out-of-pocket medical expenses.

    Learn more about Basic Medicare here.

  • What Is It? Medigap, also known as Medicare Supplemental Insurance, is offered by private insurance companies. They help fill the coverage "gaps" left open by Basic Medicare. There are 10 types of Medigap plans. They are Plans A, B, C, D, F, G, K, L, M and N. Not every insurer offers all 10 plans, and prices can vary, but the amount of coverage is the same across companies.
  • Why Get It? Many can find Basic Medicare to have too many "gaps" in coverage. Supplementing your coverage with a Medigap plan can greatly reduce the amount you pay out-of-pocket when using medical services. Multiple or extended hospitalizations (60 days or more) could cost thousands out-of-pocket. So could just one or two outpatient procedures. That is why it may be more cost effective to purchase a Medigap plan, even when factoring-in the monthly premium.
    Some Medigap plans also provide you with additional coverage, such as emergency health care when you are travelling internationally, and care at a nursing facility.
  • Who Is Eligible? To be eligible, you must be enrolled in Basic Medicare (Parts A & B).
  • When Can I Enroll? You must enroll during the Medigap Enrollment Period which begins 6 months after you turn 65. Those under 65 can enroll if they have a disability. Remember, you must have Basic Medicare to qualify for enrollment.
    If you miss the Medigap Enrollment Period, you can still get a plan. However, insurers are not required by law to accept your enrollment, and can deny you coverage based on preexisting conditions.
  • How Much Does It Cost? Premiums for Medigap plans start at around $89* per month, but vary depending on the plan you choose and the state you live in. Plan F tends to be a popular choice. It covers the deducible costs of Basic Medicare Part A ($1,316) and Part B ($183). Plan F premiums begin around $129* per month.
  • How to Enroll? You can compare leading Medigap options here on Medicare2017.org. After you find your plan, the enrollment process is simple. To begin, just enter your zip code and tell us about yourself. You can also speak with a licensed sales agent by calling () - and apply right over the phone.

    Learn more about Medigap here.

  • What Is It? Medicare Advantage plans (also known as Medicare Part C) provide your Basic Medicare benefits (Parts A & B), along with additional medical coverage, all in one convenient private insurance plan. The additional coverage limits and helps pay for your out-of-pocket medical expenses.

    Unlike Basic Medicare, many Medicare Advantage plans also include coverage for prescription drugs (also known as Part D). Medicare Advantage plans can also include dental, vision, and wellness benefits.

    Most plans tend to be HMOs or PPOs. HMOs involve a set network of doctors and hospitals. They typically require you to coordinate your care through a primary care physician, who can refer you to specialists when needed. PPOs tend to have larger networks and do not require referrals for specialists. Since Medicare Advantage HMOs and PPOs provide all of your health coverage in a single plan, they can seem similar to the insurance you may have had through an employer.

  • Why Get It? Medicare Advantage plans can substantially reduce the amount you pay out-of-pocket for health care. Basic Medicare requires you pay for 20% of medical costs when needing outpatient care. It also requires you pay several hundreds of dollars per day when hospitalized for 60 days or more. Further, there is no cap on your out-of-pocket costs. There also is no coverage for prescription drugs, meaning you pay for 100% of costs at the pharmacy.

    Medicare Advantage plans help pay for all of these out-of-pocket costs, with many plans including prescription drug coverage. They also place a "worst-case" maximum limit on your out-of-pocket costs. These limits vary from plan to plan, but can be very affordable. Medicare Advantage maximum out-of-pocket limits keep your costs both affordable and predictable.

    Some people may prefer Medicare Advantage over Medigap because they enjoy the convenience of having one plan. Medigap plans work on top of, or in addition to, Basic Medicare.

  • Who Is Eligible? Those who are eligible for Basic Medicare (Parts A & B) can enroll in Medicare Advantage. To be eligible for Basic Medicare, you must be 65 or older. Those under 65 are eligible if they are disabled.

  • When Can I Enroll? There are three enrollment periods for Medicare Advantage.
    The first is the Initial Enrollment Period. Initial Enrollment is the 7 month period surrounding your 65th birthday -- 3 months before, the month of, and 3 months after your birthday.

    You can also enroll in a Medicare Advantage Plan during the Open Enrollment Period. This year's Open Enrollment Period begins on October 15 and ends on December 7. If you already have a plan, but would like a new one, this is also the time where you are permitted to change plans.

    The last way to enroll is during the Special Enrollment Period. The Special Enrollment Period is only open to those who recently had a major life change, such as if you recently moved or lost health coverage.

    Since Special Enrollment is limited, it is important that you do not miss the Initial or Open Enrollment Periods. Your coverage can be delayed.

  • How Much Does It Cost? Monthly premiums for Medicare Advantage Plans greatly vary based on the plan you choose and the state you live in. Some plans cost $0** per month, others much more. The average premium for Medicare Advantage is around $39** per month.

  • How to Enroll? You can compare multiple Medicare Advantage options here on Medicare2017.org! After you find the right one for your needs, it is easy to apply. To begin, just enter your zip code and tell us about yourself. You can also call () - to speak with a licensed sales agent and apply right over the phone.

    Learn more about Medicare Advantage here.

  • What Is It? Basic Medicare does not include coverage for prescription drugs at the pharmacy. Fortunately, the government has allowed certain private insurers to offer Medicare Prescription Drug plans (also known as Part D).

    There are two types of plans. The first are Medicare Advantage Prescription Drug Plans (MAPDPs). This type of coverage is included as part of a Medicare Advantage plan. The other type are standalone Prescription Drug Plans (SPDPs). This is the type of coverage you get separately along with Basic Medicare or a Medigap plan.

  • Why Get It? Paying for prescription drugs out-of-pocket can be very expensive. If you are currently taking medication, or think you may need to, it is highly recommended to get a Medicare Prescription Drug Plan.
  • Who Is Eligible? You must be eligible for Basic Medicare (Parts A & B) to get a Medicare Prescription Drug plan.
  • When Can I Enroll? Both Medicare Advantage Prescription Drug Plans and Standalone Prescription Drug Plans are best purchased during the Initial Enrollment Period or the Open Enrollment Period.

    The Initial Enrollment Period is the 7 month period surrounding your 65th birthday -- 3 months before, the month of, and 3 months after your birthday. If you fail to get coverage during this time, you could face the Medicare Part D penalty.

    Next is the Open Enrollment Period, which begins on October 15 and ends on December 7. The Open Enrollment Period is also a good time to switch plans if you already have one.

    Lastly, it is possible to enroll in a drug plan after the above enrollment windows, or during the Special Enrollment Period. The Special Enrollment Period is only open to those who recently had a major life change, such as a move or a loss of health coverage.

    Since Special Enrollment is limited, it is important that you do not miss the Initial or Open Enrollment Periods. Your coverage can be delayed. You could also face a penalty for not having coverage. As of 2017, the penalty is $35.63 times the numbers of months you went without coverage. For example, if you went 36 months without Part D, you would have to pay $1,282.68 for the year.

  • How Much Does It Cost? Monthly premiums for Medicare Prescription Drug Plans vary by carrier, plan, the state you live in, and the drugs you require. Premiums for MAPDPs average around $5-$20*** per month, but can start as low as $0*** per month. SPDPs start around $11.40*** per month.

    The deductible, or the amount you have to pay before the plan kicks-in, can also greatly vary. However, by law, your deducible cannot exceed $400 per year as of 2017. Many plans have deductibles that are even more affordable.

    Also, once your total prescription drug costs exceed $3,700, the insurance temporarily pays less -- 60% for brand name and 49% for generic drug costs -- for the next $1,740 in drug costs. This coverage gap is known as the "Part D Donut Hole." After that, the plan kicks back in as catastrophic coverage and starts paying for nearly all of the new costs. Note that the Donut Hole is projected to get much better and pay for 75% of costs by 2020. Remember that most of your costs are covered before and after the Donut Hole gap.

    When shopping for a plan, it is important to compare plans apples-to-apples by formulary. The formulary is the exact drugs that the plan covers, and different formularies have different costs.

  • How to Enroll? You can compare Medicare Prescription Drug options here on Medicare2017.org! You can apply once you find the right plan for your needs. To begin, just enter your zip code and tell us about yourself. You can also call () - to with a licensed sales agent and apply over the phone.

    Learn more about Medicare Prescription Drug Plans here.