BORN IN THE FIFTIES
Part D Prescription Drug plans provide drug coverage that is not provided by Medicare Parts A and B. You can get Part D drug coverage in two different ways: Medicare Advantage Plans or standalone Prescription Drug plans. If you get a Medicare Advantage Plan, drug coverage is typically included at no cost. You may have to pay a copay for your prescriptions. If you want a Supplement plan, you can get drug coverage with a standalone plan, which typically has a premium for the coverage.
Whether you choose a Medicare Advantage plan with included drug coverage or a Supplement plan with separate drug coverage, your prescriptions costs will be similar.
Prescription’s copays are determined by what drug tier the prescription falls into. Tier 1 prescriptions are generics and will have a low to zero copay. Tier 5 prescriptions are brand name or specialty prescriptions and can be costly.
Some plans have no deductible for Tiers 1 and 2
Drug plans have different cost phases:
Deductible – The amount you must pay before your drug plan pays its share
Initial Coverage – Pay the stated copays and coinsurance for each drug according to what Tier it is in. Most people won’t leave this phase.
Coverage Gap – Temporary limit on what the drug plan will cover. You won’t pay more than 25% of the cost for your brand and generic drugs.
Catastrophic coverage – After you’ve spent over a certain amount, you’ll only pay a very small copay or coinsurance for your prescriptions for the rest of the year.
Prescription drug coverage is required by Medicare or else they will penalize you if you need it in the future. If you already have prescription drug coverage from the VA or another source, you do not need prescription drug coverage. Discount cards such as goodRx are not considered qualifying drug coverage by Medicare.
Even if you are not taking prescriptions currently, getting a low premium prescription drug plan (or one included with an Advantage plan) will keep you from being penalized.
If you want a standalone drug plan to add to your Medicare Supplement plan, you can apply for a standalone plan by filling out the form below. If you want an Advantage plan or have an Advantage plan, do not apply for a Standalone drug plan if your Advantage plan already has drug coverage.
Dental and vision plans provide routing dental and vision services not covered by Medicare. This dental care such as cleanings, fillings, crowns, and implants, as well as vision services such as exams, lenses and contacts.
Dental coverage is often included in Medicare Advantage plans at no additional cost. Some Advantage plans may have an optional dental rider to provide better benefits.
Standalone dental coverage can be added to a Medicare Supplement plan with Standalone Prescription Drug coverage.
Standalone dental coverage can be added for as low as $33.35 per month for a basic plan that covers cleanings and fillings, but not crowns, implants, or other restorative services.
If you want coverage for crowns, implants, and other restorative services, a Premium dental plan costs $68.35 per month.
Vision coverage can be added to dental coverage for as low as $12.50 per month, or $15.55 per month for a higher frame/lens allowance.
Dental and vision coverage is NOT required by Medicare to avoid penalties, unlike drug coverage and medical coverage.
If you have an Advantage plan, review your included dental benefits before getting a standalone dental and vision plan.
If you have a Supplement plan or want a Supplement plan, click the button below to view dental and vision plans.
If you want to view Vision plans, you’ll need to click the enroll button on a dental plan to view a vision plan. This will not enroll you until you want to move forward.
Medicare Advantage plans provide your Medicare Benefits through coordinated care providers like HMOs and PPOs.
Advantage plans are typically free and offer many perks that Original Medicare, Part A and Part B, do not.
Original Medicare, Part A and Part B do not limit your out of pocket expenses in the event of a chronic diagnoses or costly emergency. Medicare Advantage plans have an out of pocket max to limit your expenses in the event of a chronic illness diagnoses or costly emergency.
Advantage plans also typically include drug coverage, as well as dental and vision coverage, as well as other perks such as gym memberships, over the counter supplement benefits and more.
You must use approved providers to use your care. With an HMO network, you may only see in-network providers unless there is an emergency. In a PPO network there is more provider flexibility. If you want to see a provider that is out of network with a PPO, you will pay a higher out of pocket cost for the same procedure.
A typical out of pocket max for an Advantage plan is $6,700 per year, but they can be lower or higher depending on the plan. PPO plans have a separate out of pocket maximum for out of network costs. A typical combined in and out of network for a PPO plan can be up to $11,000, so you will want to visit in-network providers when possible.
When can you sign up?
If you are turning 65, you can enroll for an Advantage plan in your Initial enrollment onto Medicare.
If you’re on just Part A and Part B, with or without a Supplement plan, you can enroll in an Advantage plan during the Annual Election (Open Enrollment) Period in October through December.
If you’re on an Advantage plan and want to switch to another Advantage plan, you will also need to do so in the Annual Election Period.
Medicare Advantage Plans
Pros | Cons |
Lowest cost option compared to supplement plans Typically include drug, dental and vision coverage Guaranteed issue regardless of health | Highest out of pocket risk compared to other options Must use provider networks such as an HMO or PPO Can only switch plans during enrollment windows |
Medicare Supplement plans fill the out-of-pocket gaps in coverage left by Medicare.
The main gap left by Medicare is a 20% out of pocket cost for any of your Medical (Part B) costs. This 20% expense is unlimited if you only have Part A and Part B coverage. There are also other copays and deductibles if you are hospitalized (Part A).
This Medicare Supplement Plan High Deductible G covers your out-of-pocket costs for Part A and Part B after you have met a $2.490 annual deductible. After you have met your deductible of $2,490, you pay no more for your medical expenses for the rest of the year.
This plan covers a maximum of 365 days in a hospital, and a maximum of 100 days in a Skilled Nursing Facility.
Supplement Plans do not have hospital networks because they work with Original Medicare, Part A and Part B. This means you can see any doctor in the US, as long as they accept Medicare (98% do). [1]
The Supplement Plan High Deductible G also includes an international travel benefit—80% coverage after a $250 separate deductible, up to a lifetime maximum of $50,000.
- If you are new to Medicare, you can apply for a supplement plan with guaranteed issue (cannot be denied due to pre-existing conditions) withing 6 months of your Part B effective Date (found on your Medicare card).
- If you are past that 6 month guaranteed issue period, you can still apply for a Supplement plan but you may need to pass a health questionnaire to be accepted.
- If you are currently on a different Supplement plan, you may apply for this Supplement plan without needing to take a health questionnaire if you are in Washington state. If you are outside of Washington state, you will likely have to pass the health questionnaire to be accepted.
- If you are currently on a Medicare Advantage plan, you can move to this Supplement plan when your Medicare Advantage plan contract is up, which is December 31st of any given year. You will need to pass the health questionnaire to be accepted.
We make the application process easy, just fill out the application below.
You will also need prescription drug coverage and dental and vision coverage. The application will redirect you
Medicare Supplement High Deductible G
Pros | Cons |
Lower Premium compared to the standard Plan GProvider Flexibility (no networks)International Travel benefitNo enrollment windows | Higher deductible compared to the standard Plan GStill more expensive than $0 Advantage plansRates can increase at any timeNot always guaranteed issueNo included drug, dental, or vision coverage |
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Medicare Supplement plans fill the out-of-pocket gaps in coverage left by Medicare.
The main gap left by Medicare is a 20% out of pocket cost for any of your Medical (Part B) costs. This 20% expense is unlimited if you only have Part A and Part B coverage. There are also other copays and deductibles if you are hospitalized (Part A).
This Medicare Supplement Plan G covers your out-of-pocket costs for Part A and Part B except for a $233 annual deductible. After you have met your deductible of $233, you pay no more for your medical expenses for the rest of the year.
This plan covers a maximum of 365 days in a hospital, and a maximum of 100 days in a Skilled Nursing Facility.
Supplement Plans do not have hospital networks because they work with Original Medicare, Part A and Part B. This means you can see any doctor in the US, as long as they accept Medicare (98% do). [1]
The Supplement Plan G also includes an international travel benefit—80% coverage after a $250 separate deductible, up to a lifetime maximum of $50,000.
If you are new to Medicare, you can apply for a supplement plan with guaranteed issue (cannot be denied due to pre-existing conditions) withing 6 months of your Part B effective Date (found on your Medicare card).
If you are past that 6 month guaranteed issue period, you can still apply for a Supplement plan but you may need to pass a health questionnaire to be accepted.
If you are currently on a different Supplement plan, you may apply for this Supplement plan without needing to take a health questionnaire if you are in Washington state. If you are outside of Washington state, you will likely have to pass the health questionnaire to be accepted.
If you are currently on a Medicare Advantage plan, you can move to this Supplement plan when your Medicare Advantage plan contract is up, which is December 31st of any given year. You will need to pass the health questionnaire to be accepted.
We make the application process easy, just fill out the application below.
Medicare Supplement G
Pros | Cons |
Highest out of pocket protection on MedicareProvider Flexibility (no networks)International Travel benefitNo enrollment windows | Higher premium than other optionsRates can increase at any timeNot always guaranteed issueNo included drug, dental, or vision coverage |