Medicare “Traditional Medicare”
Medicare is a U.S. federal health insurance program for people aged 65 and older, as well as certain younger individuals with disabilities or specific medical conditions. It's divided into four parts:
Part A: Hospital insurance
Part B: Medical insurance
Medicare Advantage “Part C”
Medicare Advantage (Part C) is a health insurance plan providing Medicare benefits through private companies. It serves as an alternative to Original Medicare (Parts A and B) and typically covers all Original Medicare services, often including additional benefits like dental, vision, and wellness programs.
January 1st to March 31st 2025
During this time, if you’re already enrolled in a Medicare Advantage plan, you have the opportunity to switch to a different Medicare Advantage plan or return to Original Medicare and join a separate Medicare drug plan
Prescription Plans “Part D”
Medicare Part D is the prescription drug coverage part of Medicare. Part D plans are offered by private insurance companies and can be either stand-along plans for those with Original Medicare or included as part of a Medicare Advantage plan.
Plans have a list of covered drugs called a formulary and drugs are placed into different tiers, which determine the cost-sharing for each medication.
Some Key Updates in 2025
1. Out-of-Pocket drug cost cap: Starting in 2025 there will be a cap of $2,000 on out-of-pocket prescription drug costs for Medicare Part D. This aims to make medications more affordable for beneficiaries.
2. Elimination of the “Donut Hole”: The infamous coverage gap “donut hole,” in Medicare Part D will be eliminated.
3. There will be a new payment plan to help pay for the cost of medication. The payment plan spread out into a 12 month payment plan.
Medicare Supplement Insurance “Medigap”
Medicare Supplement Insurance Plans also known as “Medigap” are designed to help cover some of the out-of-pocket costs that Original Medicare (Part A and Part B) does not cover. These plans can include copayments, coinsurance, and deductibles.
Medigap plans are sold by private companies and are standardized meaning that plans with the same letter offer the same benefits, regardless of the insurance.