Medicare covers many of your health care needs. Today’s Medicare is working with private companies approved by Medicare that provide different ways to get your health care and prescription drug coverage in the Medicare Program. The Medicare plan that you choose affects many things like cost, benefits, doctor choice, convenience, and quality. For more information please refer to the Government Handbook – Medicare & You.
Your Medicare plan choices include:
The Original Medicare Plan (Medicare A & B)
This is a fee-for-service plan that covers many health care services and certain drugs. You can go to any doctor or hospital that accepts Medicare. When you get your health care, you use your red, white, and blue Medicare card.
The Original Medicare Plan pays for many health care services and supplies, but it doesn’t pay all of your health care costs. There are costs that you must pay, like coinsurance, co-payments, and deductibles. These costs are called “gaps” in Medicare coverage. You might want to consider buying a Medigap policy (also called a Medicare Supplement policy) to cover the gaps in Medicare coverage.
These health insurance plans are sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. There are 10 standard Medicare supplement health care policies - plan A thru N. With companies offering the same standardized insurance plans, your Medicare supplement choice comes down to price and a company’s service, reputation and experience with Medicare supplement insurance policies. You can also add prescription drug coverage by purchasing a Medicare Prescription Drug Plan (see below).
We offer Medigap coverage through the following insurers;
- Regence BlueShield offers four out of the 10 Medicare Supplement plans (A, C, F & K) to enrollees in their service area who are over age 65 and enrolled on Medicare Parts A and B.
- Premera Blue Cross offers four out of the 10 Medicare Supplement plans (A, F, F High Deductible & N) to State wide enrollees (except those living in Clark County) who are over age 65 and enrolled on Medicare Parts A and B. If you are under age 65 and eligible for Medicare due to a disability, Plan A is the only option available to you.
Medicare Advantage Plans
Available in many areas, (formally known as Medicare Part C); these plans may cover more services and may have lower out-of-pocket costs than the Original Medicare Plan. Some plans cover prescription drug coverage. Most of these plans have a limited selection of doctors and hospitals that you must use for your care. If you have one of these plans, you don’t need a Medigap policy but you must enroll in the original Medicare Parts A & B.
We offer Medigap coverage through Regence BlueShield;
- Regence MedAdvantage is a PPO with a Medicare Advantage contract. They have basic MedAdvantage along with two plans MedAdvantage + Rx Classic and Regence MedAdvantage + Rx Enhanced, which include affordable Part D prescription drug coverage.
Medicare Prescription Drug Plans (Medicare Part D)
These stand-alone plans add prescription drug coverage to the Original Medicare Plan. Penalties can apply if you do not enroll when you are first eligible for this coverage.
We offer Medicare Prescription Drug Plans through the following insurer;
All drug plans approved by Medicare must offer the standard level of coverage set by Congress. Some plans provide additional savings and more coverage.
The standard drug benefit provides an initial level of prescription drug coverage, and protection for those with very high drug costs (known as catastrophic coverage)
(If you have one)
|Up to $320
||Up to $325
|Initial Coverage Limit
(Total of what you and your plan pay)
||In 2012 you get a 50% discount on brand name drugs and pay 86% for generic drugs.
||In 2013 you get a 52.5% discount on brand name drugs and pay 79% for generic drugs.
||Once your True Out-Of Pocket (TrOOP) costs reach $4,700 Medicare is responsible for 95% of your drug costs for the remainder of the year
||Once your True Out-Of Pocket (TrOOP) costs reach $4,750 Medicare is responsible for 95% of your drug costs for the remainder of the year