What is Medicare?

Medicare is health insurance for people 65 or older, people under 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant). 



What are the different parts of Medicare?

Medicare Part A (Hospital Insurance) helps cover: 
■ Inpatient care in hospitals
■ Skilled nursing facility care 
■ Hospice care 
■ Home health care

Medicare Part B (Medical Insurance) helps cover: 
■ Services from doctors and other health care providers 
■ Outpatient care 
■ Home health care 
■ Durable medical equipment 
■ Some preventive services

Medicare Part C (Medicare Advantage): 
■ Includes all benefits and services covered under Part A and Part B 
■ Usually includes Medicare prescription drug coverage (Part D) as part of the plan 
■ Run by Medicare-approved private insurance companies 
■ May 
include extra benefits and services for an extra cost

Medicare Part D (Medicare prescription drug coverage): 
■ Helps cover the cost of prescription drugs 
■ Run by Medicare-approved private insurance companies 
■ May help lower your prescription drug costs and help protect against higher costs in the future 



What’s NOT covered by Part A and Part B?
Medicare doesn’t cover everything. If you need certain services that aren’t covered under Medicare Part A or Part B, you’ll have to pay for them yourself unless: 
■ You have other coverage (including Medicaid) to cover the costs. 
■ You’re in a Medicare health plan that covers these services. Even if Medicare covers a service or item, you generally have to pay deductibles, coinsurance, and copayments.

Some of the items and services that Medicare doesn’t cover include: 
✘  Most dental care. 
✘  Eye examinations related to prescribing glasses. 
✘  Dentures. 
✘ Cosmetic surgery. 
✘ Acupuncture. 
✘ Hearing aids and exams for fitting them. 
✘ Long-term care. 

Note: If you need help with coverage of the above items, please feel free to contact us. 



How can I get my Medicare coverage?


You can choose different ways to get your Medicare coverage: 
1. You can choose Original Medicare. If you want prescription drug coverage, you must join a Medicare Prescription Drug Plan (Part D). If you don’t join a Medicare drug plan when you’re first eligible, and you don’t have other creditable prescription drug coverage (for example, from an employer or union), you may pay a late enrollment penalty if you choose to join later. 

2. You can choose to join a Medicare Advantage Plan (like an HMO or PPO) if one’s available in your area. The Medicare Advantage Plan may include Medicare prescription drug coverage. In most cases, you must take the drug coverage that comes with the Medicare health plan if it’s offered. In some types of plans that don’t offer drug coverage, you may be able to join a Medicare Prescription Drug Plan. If you would like to get more information about types of plans offered in your area, please contact us at: 415-994-4121. Or feel free to email us anytime. 

If you don’t join a Medicare Advantage Plan, you’ll have Original Medicare. 



What are my Medicare coverage choices?

There are 2 main ways to get your Medicare coverage
Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Use these steps to help you decide which way to get your coverage:

                   
 Step 1: Decide if you want Original Medicare or a Medicare Advantage Plan

 You can choose Original Medicare. 

Here are some things you should know:

What is Original Medicare?

Part A (Hospital Insurance) and Part B (Medical Insurance).

Who provides coverage?

Medicare provides this coverage.

How do you choose your providers?

You have your choice of doctors, hospitals, and other providers that accept Medicare.

Who pays the premiums?

You usually pay a monthly premium for Part B.

Who pays deductibles and coinsurance?

Generally, you or your supplement coverage pay deductibles and coinsurance.

You can choose a Medicare Advantage Plan (like an HMO or PPO). 

Here are some things you should consider about Medicare Advantage Plans:

What is it?

Part C – includes both Part A (Hospital Insurance) and Part B (Medical Insurance).

Who provides coverage?

Private insurance companies approved by Medicare provide this coverage.

How do you choose your providers?

In most plans, you need to use plan doctors, hospitals, and other providers or you pay more or all of the costs.

Who pays the premiums?

You usually pay a monthly premium (in addition to your Part B premium).  

Who pays deductibles and coinsurance?

You may pay a copayment or coinsurance for covered services. Costs, extra coverage, and rules vary by plan.



                 
   Step 2: Decide if you want prescription drug coverage (Part D)

 -You choose Original Medicare.  If you want this coverage, you must choose and join a Medicare Prescription Drug Plan. You usually pay a monthly premium. These plans are run by private companies approved by Medicare.

-You choose a Medicare Advantage Plan.   If you want prescription drug coverage, and it's offered by your plan, in most cases you must get it through your plan. In some types of plans that don't offer drug coverage, you can join a Medicare Prescription Drug Plan.

                 
   Step 3: Decide if you want supplemental coverage (Original Medicare only)

You may want to get coverage that fills gaps in Original Medicare coverage. You can choose to buy a Medicare Supplement Insurance (Medigap) policy from a private company. Costs vary by policy and company.  Employers/unions may offer similar coverage. Please feel free to get a free quote online: 




*Note

If you join a Medicare Advantage Plan, you can't use Medicare Supplement Insurance (Medigap) to pay for out-of-pocket costs you have in a Medicare Advantage Plan. If you already have a Medicare Advantage Plan, you can't be sold a Medigap policy. You can only use a Medigap policy if you disenroll from your Medicare Advantage Plan and return to Original Medicare.

Other options
In addition to Original Medicare or a Medicare Advantage Plan, you may be able to join other types of Medicare health plans.  
You may be able to save money or have other choices if you have limited income and resources.
You may also have other coverage, like employer or union, military, or veterans' benefits. Feel free to reach us if you don't know or are confused about all the options! 




Signing Up for Medicare Part A & Part B
Some people get Part A and Part B automatically



If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), you’ll automatically get Part A and Part B starting the first day of the month you turn 65. (If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.) If you’re under 65 and disabled, you’ll automatically get Part A and Part B after you get disability benefits from Social Security for 24 months or certain disability benefits from the RRB for 24 months. If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease), you’ll get Part A and Part B automatically the month your disability benefits begin. 
If you’re automatically enrolled - you’ll get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or 25th month of disability benefits. If you’re going to wait to get Part B, follow the instructions that come with the card, and send the card back. If you keep the card, you keep Part B and will pay Part B premiums. 

























If I’m not automatically enrolled in Medicare, when can I sign up?

If you want Part A and/or Part B, you can sign up during the times listed below. In most cases, if you don’t sign up for Medicare when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Part B. 

Initial Enrollment Period 

You can sign up for Part A and/or Part B during the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. If you sign up for Part A and/or Part B during the first 3 months of your Initial Enrollment Period, in most cases, your coverage starts the first day of your birthday month. However, if your birthday is on the first day of the month, your coverage will start the first day of the prior month. 
If you enroll in Part A and/or Part B the month you turn 65 or during the last 3 months of your Initial Enrollment Period, the start date for your Medicare coverage will be delayed. 

General Enrollment Period 
If you didn’t sign up for Part A and/or Part B (for which you must pay premiums) during your Initial Enrollment Period and you aren’t eligible for a Special Enrollment Period (see below), you can sign up between January 1–March 31 each year. Your coverage will begin July 1 of that year. You may have to pay a higher Part A and/or Part B premium for late enrollment.

Special Enrollment Period

 Once your Initial Enrollment Period ends, you may have the chance to sign up for Medicare during a Special Enrollment Period. If you didn’t sign up for Part A and/or Part B when you were first eligible because you’re covered under a group health plan based on current employment (your own, a spouse’s, or if you’re disabled, a family member’s), you can sign up for Part A and/or Part B: 
■ Anytime you’re still covered by the group health plan 
■ During the 8-month period that begins the month after the employment ends or the coverage ends, whichever happens first

Usually, you don’t pay a late enrollment penalty if you sign up during a Special Enrollment Period. This Special Enrollment Period doesn’t apply to people with End-Stage Renal Disease (ESRD).  You may also qualify for a Special Enrollment Period if you’re a volunteer serving in a foreign country. 
COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage and retiree health plans aren’t considered coverage based on current employment. You’re not eligible for a Special Enrollment Period when that coverage ends. To avoid paying a higher premium, make sure you sign up for Medicare when you’re first eligible. 



Medicare and the Health Insurance Marketplace


Te Health Insurance Marketplace, a key part of the 
Affordable Care Act, is a way for qualified individuals, families, and qualified employees of small businesses to get health coverage. Medicare isn’t part of the Marketplace. 

If I have Medicare, do I need to do anything? 


As long as you have Medicare Part A coverage, you’re considered covered and you don’t have to get any additional coverage. If you only have Medicare Part B, you aren’t considered to have minimum essential coverage.
This means you may have to pay a fee for not having coverage. 

Can I get a Marketplace plan instead of Medicare, or can I get a Marketplace plan in addition to Medicare? 


Generally, no. It’s against the law for someone who knows you have Medicare to sell you a Marketplace plan because that would duplicate your coverage. However, if you’re employed and your employer offers employer-based coverage through the Marketplace, you may be eligible to get that type of coverage. 
Note: Te Marketplace doesn’t 
offer Medicare Supplement Insurance (Medigap) policies, Medicare Advantage Plans, or Medicare drug plans (Part D). 

What if I become eligible for Medicare after I join a Marketplace plan? 


You can get a Marketplace plan to cover you before your Medicare coverage begins. You can cancel the Marketplace plan when your Medicare coverage starts. When you’re eligible for Medicare, you’ll have an Initial Enrollment Period to sign up. In most cases it’s to your advantage to sign up when you’re first eligible because: 


■ When you’re considered eligible for Medicare Part A, you won’t qualify for Marketplace tax credits to help pay your premiums or reductions in cost-sharing that may be available through the Marketplace. 
■ If you enroll in Medicare 
after your Initial Enrollment Period ends, you may have to pay a late enrollment penalty for as long as you have Medicare. 


Note: You can keep your Marketplace plan after your Medicare coverage starts. However, once your Part A coverage starts, any premium tax credits and reduced cost-sharing you get through the Marketplace will stop

How much does Part A coverage cost? 


You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working. This is sometimes called premium-free Part A. If you aren’t eligible for premium-free Part A, you may be able to buy Part A if: 
■ You’re 65 or older, and you have (or are enrolling in) Part B and meet the citizenship and residency requirements. 
■ You’re under 65, disabled, and your premium-free Part A coverage ended because you returned to work. (If you’re under 65 and disabled, you can continue to get premium-free Part A for up to 8 1/2 years 
after you return to work.) 
Note: Some people who had to buy Part A pay up to $426 each month. (usually, you get Part A for free) 



 Most people get premium-free Part A. You can get premium-free Part A at 65 if:

  • You already get retirement benefits from Social Security or the Railroad Retirement Board.
  • You're eligible to get Social Security or Railroad benefits but haven't filed for them yet.
  • You or your spouse had Medicare-covered government employment.


If you're under 65, you can get premium-free Part A if:

  • You got Social Security or Railroad Retirement Board disability benefits for 24 months.
  • You have End-Stage Renal Disease (ESRD) and meet certain requirements.

In most cases, if you choose to buy Part A, you must also have Part B and pay monthly premiums for both. If you have limited income and resources, your state may help you pay for Part A and/or Part B.

What’s the Part A late enrollment penalty?


 If you aren’t eligible for premium-free Part A, and you don’t buy it when you’re first eligible, your monthly premium may go up 10% when you decide to enroll. You’ll have to pay the higher premium for twice the number of years you could have had Part A, but didn’t sign up. 
Example: If you were eligible for Part A for 2 years but didn’t sign up, you’ll have to pay the higher premium for 4 years. Usually, you don’t have to pay a penalty if you meet certain conditions that allow you to sign up for Part A during a Special Enrollment Period.

How much does Part B coverage cost? 


You pay the Part B premium each month. Most people will pay the standard premium amount, which is $121.80 in 2016
Some people may pay a higher Part B premium If your modified
 adjusted gross income as reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS) is above a certain amount ($85,000 if you file individually or $170,000 if you’re married and file jointly), you may pay more. This doesn’t affect everyone, so most people won’t have to pay a higher amount. Your modified adjusted gross income is your adjusted gross income plus your tax-exempt interest income.

What’s the Part B late enrollment penalty? 


If you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn’t sign up for it. Usually, you don’t pay a late enrollment penalty if you meet certain conditions that allow you to sign up for Part B during a Special Enrollment Period.
Example: Mr. Smith’s Initial Enrollment Period ended September 30, 2011. He waited to sign up for Part B until March 2014 during the General Enrollment Period. His Part B premium penalty is 20%. (Even though Mr. Smith waited a total of 30 months to sign up, this included only 2 full 12-month periods.) He’ll have to pay this penalty for as long as he has Part B.


What are Medicare Advantage Plans?


A Medicare Advantage Plan (like an HMO or PPO) is another way to get your Medicare coverage. If you join a Medicare Advantage Plan, you still have Medicare. You’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are 
offered by private companies that Medicare approves.


Medicare Advantage Plans cover all Medicare services In all types of Medicare Advantage Plans, you’re always covered for emergency and urgent care. Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care and some care in qualifying clinical research studies. Original Medicare covers hospice care and some costs for clinical research studies, even if you’re in a Medicare Advantage Plan. Medicare Advantage Plans may 
offer extra coverage, like vision, hearing, dental, and other health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you might pay a monthly premium for the Medicare Advantage Plan. 

What are the different types of Medicare Advantage Plans? 


■ Health Maintenance Organization (HMO) plans—In most HMOs, you can only go to doctors, other health care providers, or hospitals in the plan’s network except in an urgent or emergency situation. You may also need to get a referral from your primary care doctor for tests or to see other doctors or specialists. 
■ Preferred Provider Organization (PPO) plans—In a PPO, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. You usually pay more if you use doctors, hospitals, and providers outside of the network. 
■ Private Fee-for-Service (PFFS) plans—PFFS plans are similar to Original Medicare in that you can generally go to any doctor, other health care provider, or hospital as long as they agree to treat you. Te plan determines how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care.  
■ Special Needs Plans (SNPs)—SNPs provide focused and specialized health care for 
specific groups of people, like those who have both Medicare and Medicaid, live in a nursing home or have certain chronic medical conditions.
■ HMO Point-of-Service (HMOPOS) plans—Tese are HMO plans that may allow you to get some services out-of-network for a higher copayment or coinsurance. 
■ Medical Savings Account (MSA) plans—Tese plans combine a high-deductible health plan with a bank account. Medicare deposits money into the account (usually less than the deductible). You can use the money to pay for your health care services during the year. MSA plans don’t 
offer Medicare drug coverage. If you want drug coverage, you have to join a Medicare Prescription Drug Plan.

















Prescription Drug Coverage 
You usually get prescription drug coverage (Part D) through the Medicare Advantage Plan. In certain types of Medicare Advantage Plans (PFFS or MSA plans) that don’t offer drug coverage, you can join a Medicare Prescription Drug Plan. If your Medicare Advantage Plan includes prescription drug coverage and you join a Medicare Prescription Drug Plan, you’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare

Who can join? 


You must meet these conditions to join a Medicare Advantage Plan: 
■ You have Part A and Part B. 
■ You live in the plan’s service area. 
■ You don’t have End-Stage Renal Disease (ESRD), except as explained later in this section.

 What if I have other coverage? 


Talk to your employer, union, or other benefits administrator about their rules before you join a Medicare Advantage Plan. In some cases, joining a Medicare Advantage Plan might cause you to lose your employer or union coverage. If you lose coverage for yourself, you may also lose coverage for your spouse and dependents. In other cases, if you join a Medicare Advantage Plan, you may still be able to use your employer or union coverage along with the plan you join. Remember, if you drop your employer or union coverage, you may not be able to get it back. What if I have a Medicare Supplement Insurance (Medigap) Policy?  You can’t use (and can’t be sold) a Medicare Supplement Insurance (Medigap) policy while you’re in a Medicare Advantage Plan. You can’t use it to pay for any expenses (copayments, deductibles, and premiums) you have under a Medicare Advantage Plan. If you already have a Medigap policy and join a Medicare Advantage Plan, you’ll probably want to drop your Medigap policy.  If you drop your Medigap policy, you may not be able to get it back.

What if I have End-Stage Renal Disease (ESRD)?


 If you have End-Stage Renal Disease (ESRD), you can only join a Medicare Advantage Plan in certain situations: 
■ If you’re already in a Medicare Advantage Plan when you develop ESRD, you can stay in your plan or you may be able to join another Medicare Advantage Plan offered by the same company. 
■ If you’re in a Medicare Advantage Plan, and the plan leaves Medicare or no longer provides coverage in your area, you have a one-time right to join another Medicare Advantage Plan. 
■ If you have an employer or union health plan or other health coverage through a company that offers one or more Medicare Advantage Plan(s), you may be able to join one of that company’s Medicare Advantage Plans. 
■ If you’ve had a successful kidney transplant, you may be able to join a Medicare Advantage Plan. 
■ You may be able to join a Medicare Special Needs Plan (SNP) that covers people with ESRD if one is available in your area.
Note: If you have ESRD and Original Medicare, you may join a Medicare Prescription Drug Plan

What do I pay? 

Your out-of-pocket costs in a Medicare Advantage Plan depend on: 
■ Whether the plan charges a monthly premium in addition to your monthly Part B premium. 
■ Whether the plan pays any of your monthly Part B premium. 
■ Whether the plan has a yearly deductible or any additional deductibles for certain services. 
■ How much you pay for each visit or service (copayments or coinsurance). 
■ Te type of health care services you need and how often you get them. 
■ Whether you go to a doctor or supplier who accepts assignment (if you’re in a Preferred Provider Organization, Private Fee-for-Service Plan, or Medical Savings Account Plan and you go out-of-network).  
■ Whether you follow the plan’s rules, like using network providers. 
■ Whether you need extra benefits and if the plan charges for them. 
■ The plan’s yearly limit on your out-of-pocket costs for all medical services. Once you reach this limit, you’ll pay nothing for covered services. 
■ Whether you have Medicaid or get help from your state.

When can I join, switch, or drop a Medicare Advantage Plan? 
■ When you first become eligible for Medicare, you can join during the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. 
■ If you get Medicare due to a disability, you can join during the 7-month period that begins 3 months before your 25th month of disability and ends 3 months after your 25th month of disability. 
■ Between
October 15–December 7 anyone with Medicare can join, switch, or drop a Medicare Advantage Plan. Your coverage will begin on January 1, as long as the plan gets your request by December 7. 

Can I make changes to my coverage after December 7? 

Between January 1–February 14, if you’re in a Medicare Advantage Plan, you can leave that plan and switch to Original Medicare. If you switch to Original Medicare during this period, you’ll have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment request. During this period, you can’t: 
■ Switch from Original Medicare to a Medicare Advantage Plan. 
■ Switch from one Medicare Advantage Plan to another. 
■ Switch from one Medicare Prescription Drug Plan to another. 
■ Join, switch, or drop a Medicare Medical Savings Account Plan.

Special Enrollment Periods 
In most cases, you must stay enrolled for the calendar year starting the date your coverage begins. However, in certain situations, you may be able to join, switch, or drop a Medicare Advantage Plan during a Special Enrollment Period. Some examples are: 
■ You move out of your plan’s service area. 
■ You have Medicaid. 
■ You qualify for extra help 
■ You live in an institution (like a nursing home).

5-Star Special Enrollment Period 

-Medicare uses information on plan performance including how good the care is and the results of care, as well as surveys from members to rate the overall performance of Medicare Advantage Plans. A Medicare Advantage Plan can get an overall rating between 1 and 5 stars. A 5-star rating is considered excellent. These ratings help you compare Medicare Advantage Plans based on quality and performance. These ratings are updated each fall and can change each year. You can switch to a Medicare Advantage Plan or Medicare Cost Plan that has 5 stars for its overall star rating. 


■ You can only join a 5-star Medicare Advantage Plan or Medicare Cost Plan if one is available in your area. 
■ You can only use this Special Enrollment Period once during the above timeframe. For more information about overall star ratings, visit Medicare.gov. You may lose your prescription drug coverage if you move from a Medicare Advantage Plan that has drug coverage to a 5-star Medicare Advantage Plan that doesn’t. You’ll have to wait until the next Open Enrollment Period to get drug coverage, and you may have to pay a late enrollment penalty.



What are Medicare Supplement Insurance (Medigap) Policies?
Original Medicare pays for many, but not all, health care services and supplies. Medicare Supplement Insurance policies, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Medicare Supplement Insurance policies are also called Medigap policies.
Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Ten, your Medigap policy pays its share. You have to pay the premiums for a Medigap policy. 


















We will be glad to provide more information and a personalized supplemental plan quote 



Medigap policies are standardized Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only a “standardized” policy identified in most states by letters A through D, F through G, and K through N. All policies offer the same basic benefits, but some offer additional benefits so you can choose which one meets your needs. In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way. Note: Plans E, H, I, and J are no longer available to buy, but if you already have one of those policies, you can keep it. Contact your insurance company for more information. 

How do I compare Medigap policies? 


Different insurance companies may charge different premiums for the same exact policy. As you shop for a policy, be sure you’re comparing the same policy (for example, compare Plan A from one company with Plan A from another company). In some states, you may be able to buy a type of Medigap policy called Medicare SELECT (a policy that requires you to use specific hospitals and, in some cases, specific doctors or other health care providers to get full coverage). If you buy a Medicare SELECT policy, you have the right to change your mind within 12 months and switch to a standard Medigap policy.

What else should I know about Medicare Supplement Insurance (Medigap)? 


Important facts 
■ You must have Part A and Part B. 
■ You pay the private insurance company a monthly premium for your Medigap policy in addition to your monthly Part B premium that you pay to Medicare. Contact the company to find out how to pay your premium. 
■ A Medigap policy only covers one person. Spouses must buy separate policies. 
■ You can’t have prescription drug coverage in both your Medigap policy and a Medicare drug plan.
 It’s important to compare Medigap policies since the costs can vary and may go up as you get older. Some states limit Medigap premium costs. 

When to buy?


 ■ The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This 6-month period begins on the first day of the month in which you’re 65 or older and enrolled in Part B. (Some states have additional Open Enrollment Periods.) After this enrollment period, your option to buy a Medigap policy may be limited and it may cost more. 
■ If you delay enrolling in Part B because you have group health coverage based on your (or your spouse’s) current employment, your Medigap Open Enrollment Period won’t start until you sign up for Part B. 
■ Federal law doesn’t require insurance companies to sell Medigap policies to people under 65. If you’re under 65, you might not be able to buy the Medigap policy you want, or any Medigap policy, until you turn 65. However, some states require Medigap insurance companies to sell Medigap policies to people under 65.

How does Medigap work with Medicare Advantage Plans? 


■ If you have a Medicare Advantage Plan, it’s illegal for anyone to sell you a Medigap policy unless you’re switching back to Original Medicare. If you want to switch to Original Medicare and buy a Medigap policy, find out what policies are available to you and contact your Medicare Advantage Plan to see if you’re able to disenroll. You’ll need to let the Medigap insurer know the date your plan coverage will end. If you don’t intend to leave your Medicare Advantage Plan, and someone tries to sell you a Medigap policy, report it to your State Insurance Department. 
■ If you have a Medigap policy and join a Medicare Advantage Plan (like an HMO or PPO), you may want to drop your Medigap policy. Your Medigap policy can’t be used to pay your Medicare Advantage Plan copayments, deductibles, and premiums. If you want to cancel your Medigap policy, contact your insurance company. In most cases, if you drop your Medigap policy to join a Medicare Advantage Plan, you won’t be able to get it back. 
■ If you join a Medicare Advantage Plan for the first time, and you aren’t happy with the plan, you’ll have special rights to buy a Medigap policy if you return to Original Medicare within 12 months of joining. —If you had a Medigap policy before you joined, you may be able to get the same policy back if the company still sells it. If it isn’t available, you can buy another Medigap policy.  —If you joined a Medicare Advantage Plan when you were first eligible for Medicare, you can choose from any Medigap policy within the first year of joining. —The Medigap policy can no longer have prescription drug coverage even if you had it before, but you may be able to join a Medicare Prescription Drug Plan.

(Source Medicare and You Handbook)

Confused? Contact us for a consultation. We make house calls at no cost (within Bay Area).
















please feel to contact Diana at: 415-994-4121. Calling this number will direct you to a licensed Agent/Broker.









This is a sample Medicare Card

Close

Learn what is: 

- deductible 

- coinsurance 

- co-payment