top of page

Pathways for Medicare

Styled Garden

1

Medicare Supplement (Medigap)

A Medicare Supplement plan is a policy that you purchase from a private health insurance company to help pay any out-of-pocket expenses in Original Medicare.  These costs can include copayments, coinsurance and deductibles.  With a Supplement plan, Medicare will pay its share first and then the Supplement plan will pay its share.  Every Supplement plan available must follow federal and state laws designed to protect the beneficiary.  These plans are "standardized" meaning that each plan with the same letter must provide the same benefits no matter which private health plan you are insured through.

2

Medicare Advantage

This is a type of Medicare health plan that is offered by a private health insurance company that contracts with Medicare.  These plans replace Original Medicare and provide all the coverage for Parts A, B and D.  The type of plans included here are an HMO, PPO, Private Fee-for-Service plans, Special Needs plans and Medicare Medical Savings Account plans.  Most plans do include prescription drug coverage

3

Prescription Drug Plan (PDP)

If you have a Medigap plan, you will most likely want to purchase a prescription drug plan to pay for your medications.  Most plans will have a deductible prior to the corresponding copays.  Once in the copay phase, you will continue to pay a copay when refilling your medications until you reach $2,000 in out-of-pocket expenses.  The deductible does apply to this $2,000.  Once this limit is reached, you will not be responsible for any costs for the remainder of the calendar year.

bottom of page