Medicare policy descriptions


What is an Advantage Plan ? An Advantage plan has a Healthcare plan and a Part-D medications plan all in one policy. Many Advantage plans also include additional benefits such as limited dental, gym membership, discount hearing aids, over the counter benefits, 24/7 nurse line, wellness and health counseling. 

Generally, Advantage plans are lower in cost. However, these plans generally have higher out-of-pocket co-pays for health services and doctoring, deductibles for Part D medications and maximum-out-of-pocket limits.  Depending on the plan type, networks can be different based on geographical location. 

In many cases, Advantage plans have original Medicare cost sharing. In other words, depending on the plan, you may pay 10-20% of the total cost of some health services, as well as co-pays.  


What is a Supplemental Plan ? A Supplemental plan off-sets the cost of original Medicare (Part-A and Part-B). Supplemental plans do not have a network and are accepted where every Medical is accepted. The plan does not have any deductibles (selected riders apply), they have no co-pays for health care and you can keep your plan if you move outside of Minnesota. 

Supplemental polices do not include Part D medications, so you will need to enroll in a separate Part D medication plan. 

A Supplemental plan can only be issued the first time you are eligible for Medicare without medical underwriting.  You can apply for a Supplemental plan after you have had a Medicare Advantage policy, but you will have to undergo medical underwriting.

What is a Part D medication plan ? Original Medicare does not include Part-D medications. It is optional, but you will pay a penalty if you do not have one. Most insurance companies have two different plans to select from. All plans include a $415 yearly deductible for Tier 3 medications and in many cases no deductible for Tier 1 and Tier 2 medications. Each plan has a formulary that lists the medication covered. All plans have preferred and standard pharmacies.