Medicare Advantage Plans, also known as Part C, are offered by private insurance companies approved by Medicare. They provide all Part A and Part B benefits and often include additional services like prescription drug coverage, dental, vision, and hearing care.

In contrast, Original Medicare is a federal program that offers Part A (Hospital) and Part B (Medical) coverage but typically doesn't include these extra benefits.

To be eligible for a Medicare Advantage Plan, you must be enrolled in both Medicare Part A and Part B, reside in the plan's service area, and sign up at the right time of the year or with a special enrollment period (SEP).

Many Medicare Advantage Plans provide extra benefits not covered by Original Medicare, such as fitness programs, routine vision and dental services, and hearing aids. These additional services can enhance your healthcare coverage and overall well-being.

Additional benefits exist for those on certain levels of Medicaid, like grocery benefits, help with utilities, lower copays (Or no copays), and other savings and increases in dental, vision, hearing, and transportation benefit amounts.

Enrollment in a Medicare Advantage Plan can be done during specific periods, such as the Initial Enrollment Period when you first become eligible for Medicare, the Annual Enrollment Period from October 15 to December 7, or during Special Enrollment Periods triggered by certain life events.

You can get set up and have us as your life long agent by using the links on this page to schedule an appointment.

Auxiliary products are supplemental insurance plans designed to fill coverage gaps in your primary Medicare plan. These can include Prescription Drug Plans (Part D), Dental and Vision insurance, Hospital Indemnity plans, Long-Term Care insurance, and policies that provide payouts for critical illnesses like heart attack, stroke, or cancer. These products help manage out-of-pocket expenses and provide comprehensive coverage tailored to your needs otherwise not coered by MAPD or Medi-Gap Plans.

No, it's not permissible to have both a Medicare Advantage Plan and a Medigap (Medicare Supplement Insurance) policy simultaneously. Medigap policies are designed to work with Original Medicare, not Medicare Advantage Plans. If you have a Medicare Advantage Plan, you cannot use a Medigap policy to cover costs like copayments, deductibles, or premiums.

Most Medicare Advantage Plans include prescription drug coverage (Part D). However, it's essential to confirm that the specific plan you're considering offers this benefit, as some plans may not include drug coverage. Review the plan's formulary to ensure your medications are covered or call us and we will look it up! 1-855-701-7113.

While many Medicare Advantage Plans have low or even $0 monthly premiums, you are still responsible for paying your Part B premium. Which is $185 in 2025 unless you’re on the right level of Medicaid.

Additionally, there may be copayments, coinsurance, and out-of-pocket costs, which can vary by plan. Each plan sets its own cost structure, so it's crucial to review the details to understand your financial responsibilities.

A Medicare Supplement Plan, or Medigap, is a type of insurance sold by private companies to help cover the "gaps" in Original Medicare. (OM = Part A + Part B) These gaps include out-of-pocket costs such as copayments, coinsurance, and deductibles. Medigap policies are standardized and labeled A through N, offering varying levels of coverage depending on the plan.

Medigap policies do not cover services like prescription drugs (Part D), long-term care, dental, vision, or hearing aids. You would need separate plans to cover these additional healthcare services. Medigap is designed to supplement Original Medicare only, not replace it or really add additional benefits.

Medicare Advantage (MAPD) Enrollment Periods

Medicare Advantage Plans (MAPD) follow strict enrollment periods:

1. Initial Enrollment Period (IEP) – When you first become eligible for Medicare (turning 65 or qualifying due to disability).

   • Starts 3 months before, includes the month of, and lasts 3 months after your Medicare Part B effective date.

2. Annual Enrollment Period (AEP) – October 15 – December 7 each year.

   • You can enroll, switch, or drop a Medicare Advantage plan.

   • Coverage starts January 1 of the following year.

3. Medicare Advantage Open Enrollment Period (OEP) – January 1 – March 31.

   • If you're already enrolled in an MAPD plan, you can switch to a different MAPD plan or return to Original Medicare (and get a Part D plan if needed).

   • You cannot switch from Original Medicare to MAPD during this OEP period.

4. Special Enrollment Periods (SEP) – Based on qualifying events like:

   • Moving outside your plan’s service area.

   • Losing employer coverage.

   • Gaining Medicaid eligibility or Extra Help.

   • Enrolling in a 5-star rated plan (one-time switch allowed per year).

   • Dual Eligible Beneficiaries who are already enrolled in a MA plan can switch once every quarter from January to September.

Medicare Supplement (Medigap) Enrollment Periods

Medicare Supplement (Medigap) plans have different rules than MAPD plans:

1. Medigap Open Enrollment Period – Starts the first month you are both:

   • 65 or older

   • Enrolled in Medicare Part B

   • Lasts for 6 months

   • During this period, you have guaranteed issue rights (no health questions, no denials).

2. Guaranteed Issue Rights (Outside Open Enrollment) – You may qualify for a Medigap plan without medical underwriting if you:

   • Lose employer or union coverage.

   • Leave a Medicare Advantage plan within the first 12 months (Trial Right).

   • Your Medigap insurer goes bankrupt or misleads you.

3. Applying Outside of These Periods –

   • You can apply for a Medigap plan any time of the year, but medical underwriting may apply.

   • If you have pre-existing conditions, insurers can deny coverage or charge higher premiums unless you have a guaranteed issue right.

The Food Benefit Card is available to people on certain levels of Medicaid who are also eligible for Medicare Advantage Plans.

Some Plans for Chronic health issues like Diabetes and Heart Issues also may qualify if those plans are available in your area.

Get on our calendar or call us and we will help you look up what you qualify for. 1-855-701-7113.

The Food Benefit Card can pay for things like Groceries, Utilities, Transportation to Medical Appointments, Pet Supplies, OTC items, and more!

The OTC card (Over The Counter) is available on most but not all MAPD plans. It pays for things like vitamins, over the counter medicines, band-aids, and other health supplies a doctor would tell you to get but not write a prescription for you.

We can help you check if your current plan has the highest Food Benefit or OTC benefit. The amounts change ever year so contact us to make sure!