A Medicare supplement (Medigap) insurance, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.
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. Then your Medigap policy pays its share.
A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.
Medigap policies generally don't cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
PART "A" (Hospital)
Days 1-60 = $1,600 per Hospital Stay
Days 61-90 = $400 per day
Days 91-150 = $800 per day
Skilled Nursing Facility Benefit (Days 21-100) = $200.00 per day
PART "B" (Medical)
Annual Deductible = $226.00*
(For the High Deductible Plan F or Plan G, the new annual deductible for 2023 is $2,700*)
Be aware that Plan “N” now requires that all providers will charge a $20 Co-Pay for each physician visit.
PART "D" - Prescription Drug Plans (PDP)
Annual Deductible for 2023 is $505.00 for Most Plans – Several Plans offer a Zero Deductible, but the premiums are higher, but also the cost of drugs “MAY” be lower overall.
There are several plans that offer the “Insulin Savings Program” where your Insulin is limited to only a $35.00 maximum charge per Insulin Drug per month
Initial Coverage Limit or Threshold = $4,660 (Now you are in the Donut Hole or Coverage Gap) – You are now responsible for 25% of the retail cost of your drugs until you have spent $7,400
Out of Pocket Threshold = $7,400. Once this is reached, you pay the greater of 5% of the retail drug cost or $4.15* copay for a Generic Drug or $10.35* for a Brand Name Drug.
There are 25 Available Drug Plans in South Florida for 2023 and they vary in premium from approx. $8.40 per month to $170.10 per month.
*Subject to change
IMPORTANT: DO NOT PICK A PLAN THAT HAS LESS THAN A 3 STAR RATING OR IS LISTED AS “TOO NEW TO BE MEASURED” AS IT IS NOT RECOMMENDED.
BE AWARE THAT SOME OF THE PLANS LISTED ARE DIRECT TO CONSUMER PRODUCTS AND AN AGENT CANNOT SELL IT.
Some types of insurance aren't Medigap or Medicare Supplement plans, they include:
If you decide to drop the entire Medigap or Medicare Supplement policy, you need to be careful about the timing. For example, you may want a completely different Medigap or Medicare Supplement policy (not just your old Medigap or Medicare Supplement policy without the prescription drug coverage), or you might decide to switch to a Medicare Advantage Plan that offers prescription drug coverage.
If you drop your entire Medigap or Medicare Supplement policy and the drug coverage wasn't creditable or you go more than 63 days before your new Medicare coverage begins, you have to pay a late enrollment penalty for your Medicare Prescription Drug Plan, if you choose to join one.
