Medicare Advantage Plans
Medicare Advantage Plans include the following:
• Preferred Provider Organization (PPO) Plans
• Health Maintenance Organization (HMO) Plans
• Private Fee-for-Service (PFFS) Plans
• Medical Savings Account (MSA) Plans
• Special Needs Plans (SNP)
Medicare Advantage Plans and Medigap Policies
Important: If you have a Medigap policy and you are switching from Original
Medicare to a Medicare Advantage Plan, you don’t need and can’t use the Medigap
policy to cover deductibles, copayments, or coinsurance under the Medicare
Advantage Plan. You may choose to drop your Medigap policy, but you should talk
to your State Health Insurance Assistance Program and your current Medigap
insurance company before you do because you may not be able to get it back. If
you already have a Medicare Advantage Plan, it is illegal for anyone to sell
you a Medigap policy unless you are switching back to Original Medicare
Medicare Prescription Drug Coverage (Part D)
Medicare offers prescription drug coverage (Part D) for everyone with Medicare.
To get Medicare drug coverage, you must join a plan run by an insurance company
or other private company approved by Medicare. Each plan can vary in cost and
drugs covered. If you want Medicare drug coverage, you need to choose a plan
that works with your health coverage. Th ere are two ways to get Medicare
prescription drug coverage:
1. Medicare Prescription Drug Plans. These plans (sometimes called “PDPs”) add
drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare
Private Fee-for-Service Plans, and Medicare Medical Savings Account Plans.
2. Medicare Advantage Plans (like an HMO or PPO) or other Medicare health plans
that have prescription drug coverage. You get all of your Part A and Part B
coverage, including prescription drug coverage (Part D), through these plans.
Medicare Advantage Plans with prescription drug coverage are sometimes called
“MA-PDs.”
Medicare Prescription Drug Coverage and Medigap Policies
• If you bought your Medigap policy before January 1, 2006, you may have a
Medigap policy with prescription drug coverage. You can keep the prescription
drug coverage in that policy or you can join a Medicare Prescription Drug Plan.
If you join a Medicare Prescription Drug Plan, you must tell your Medigap
insurance company. It will remove the prescription drug coverage from your
Medigap policy. Th is is because you can’t have both types of prescription drug
coverage at the same time.
• If you have Original Medicare and already have a
Medigap policy without prescription drug coverage, you can join a Medicare
Prescription Drug Plan without changing your Medigap policy.
Can I buy a new Medigap policy that includes prescription drug
coverage?
No. New Medigap policies can’t include prescription drug coverage. Th is is
because Medicare offers prescription drug coverage to everyone with Medicare.
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