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Advantage Plans

Medicare Plan Basics

Medicare Supplement Plans

Help pay for "gaps" in Original Medicare.
Include minimal standard coverages.
Offer different enhanced coverages.
Approved by each state they are offered.

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Medicare Advantage Plans (Part C)

Work like HMO or PPO health plans.
Limit out-of-pocket expenses every year.
Require you to stay in-network for services.
Sometimes include drug coverage.

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Prescription Drug Plans (Part D)

Have a Formulary or List of Covered Drugs.
Only Formulary drugs count as out-of-pocket.
Include three levels of covered expenses.
Sometimes included in Medicare Advantage.

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Additional Resources

Medicare Providers

Because of the significant out-of-pocket payments required by traditional Medicare, a booming market of private-sector insurance products has grown up around the government programs. These Medicare-related insurance products are one of the fastest-growing segments of the U.S. health insurance industry, and they are the part of the market on which a smart consumer should focus his or her attention. Medicare Providers is here to help seniors, and other Medicare eligible individuals, understand these products and provide tools to assist in the decision making process.

The market for private-sector Medicare-related coverages can be described as including:
  • Medicare Supplement plans - sometimes called "Medigap" insurance, though some industry professionals don't like that term - which, to various degrees, cover the things traditional Medicare doesn't.
  • Medicare Part C plans, which replace traditional Medicare with any of several managed-care style programs that require little or no out-of-pocket payments.
  • Medicare Part D plans, which cover the cost of outpatient prescription drugs - and supplement either traditional Medicare or, in some cases, a Part C managed care plan.

In order to qualify for most Medicare-related plans, you must meet the standard Medicare eligibility requirements and live in the "geographic service area."

If you move out of your geographic service area during a plan's coverage term, you will usually have a Special Enrollment Period that allows you to enroll in another Medicare-related plan approved for sale in your new location or switch to back to traditional Medicare.

The number of Medicare Supplement, Part C and Part D plans available in a given area can be overwhelming. Combine that with the difficulty of finding reliable consumer information in an easy-to-understand format and you have a recipe for confusion. It's more than most people want to know about health insurance. The purpose of this web site is to give you the tools and information to make good decisions.