Medicare doesn’t have to be understood all at once.

The easier approach is to understand how the different parts fit together, decide which type of coverage fits your situation, and then compare the options available to you.

At TCG Insurance Solutions, I help Medicare beneficiaries in Kansas and Missouri understand their choices in plain English so they can make an informed decision without unnecessary pressure.

Whether you’re approaching age 65, retiring from employer coverage, already enrolled in Medicare, or simply trying to understand what comes next, this page is a good place to start.

New to Medicare? Start Here

Medicare isn’t one single insurance plan. Several different parts and coverage options work together.

Understanding those pieces first can make everything else considerably easier.

Medicare Part A — Hospital Insurance

Medicare Part A generally helps cover inpatient hospital care, skilled nursing facility care, hospice care and certain home health services.

Medicare Part B — Medical Insurance

Medicare Part B generally helps cover physician services, outpatient care, preventive services, durable medical equipment and other medically necessary services.

Together, Medicare Parts A and B are known as Original Medicare.

Original Medicare pays much of the cost of Medicare-covered healthcare, but it does not pay every expense.

That’s where some of the other Medicare coverage choices come into the picture.

Medicare Part C — Medicare Advantage

Medicare Advantage is an alternative way to receive your Medicare Part A and Part B benefits through a private insurance company approved by Medicare.

Many Medicare Advantage plans also include Part D prescription drug coverage and may offer additional benefits.

Plan premiums, provider networks, drug coverage, cost sharing and additional benefits can vary by plan and location.

Medicare Part D — Prescription Drug Coverage

Medicare Part D helps pay for prescription medications.

If you choose Original Medicare, you can generally enroll in a separate Medicare Part D prescription drug plan.

Most Medicare Advantage plans include prescription drug coverage, although plan designs can differ.

Medicare Supplement Insurance — Medigap

Medicare Supplement insurance, also called Medigap, works alongside Original Medicare.

It can help pay certain deductibles, coinsurance and copayments that would otherwise be your responsibility.

Medicare Supplement plans are standardized by plan letter. However, premiums can vary between insurance companies even when the standardized benefits are the same.

Two Different Paths for Your Medicare Coverage

One of the most important Medicare decisions is deciding how you want to receive your coverage.

Original Medicare

With Original Medicare, you have Medicare Parts A and B.

You may also choose a separate Part D prescription drug plan and can consider a Medicare Supplement policy to help with some of Original Medicare’s out-of-pocket costs.

Original Medicare generally allows you to use doctors and hospitals throughout the United States that accept Medicare.

Medicare Advantage

Medicare Advantage provides your Medicare Part A and Part B benefits through a private Medicare-approved insurance company.

Many plans bundle medical and prescription drug coverage together and may include additional benefits.

Depending on the plan, you may need to use a provider network or follow plan requirements for certain services.

Neither approach is automatically right for everyone.

Your healthcare needs, prescriptions, doctors, travel habits, budget and personal preferences can all play a role in deciding which direction makes sense.

Looking for Medicare Supplement Insurance?

Medicare Supplement insurance is one of the areas in which TCG Insurance Solutions specializes.

We’ve created detailed state-specific resources to help you understand your options.

Medicare Supplement Plans in Kansas

Learn how Medicare Supplement insurance works in Kansas, including standardized Medigap plans, enrollment considerations, Plan G, Plan N and factors to consider when comparing insurance companies.

[Button: Explore Medicare Supplement Plans in Kansas]

Medicare Supplement Plans in Missouri

Learn how Medicare Supplement insurance works in Missouri, including Plan G, Plan N, rate comparisons and Missouri’s Medicare Supplement Anniversary Rule.

[Button: Explore Medicare Supplement Plans in Missouri]

Researching Medicare Supplement Plan G?

Plan G is one of the Medicare Supplement options commonly researched by people who are new to Medicare.

It provides broad coverage for many of the out-of-pocket expenses left by Original Medicare. You remain responsible for the Medicare Part B deductible.

We’ve created separate resources for each state:

[Button: Medicare Supplement Plan G in Kansas]

[Button: Medicare Supplement Plan G in Missouri]

These pages explain what Plan G covers, what it doesn’t cover, how premiums can vary and what to consider when comparing Plan G insurance companies.

What About Medicare Supplement Plan N?

Plan N is another Medicare Supplement option worth understanding.

It provides many of the same standardized benefits as Plan G but requires the policyholder to accept some additional cost sharing, including certain office and emergency room copayments. Plan N also does not cover Medicare Part B excess charges.

For some people, that tradeoff may be worth considering in exchange for a potentially lower premium.

The right question isn’t simply, “Which plan is cheaper?”

It’s:

Which balance of premium and potential out-of-pocket expenses am I more comfortable with?

Turning 65 and Still Working?

Turning 65 doesn’t always mean that everyone should handle Medicare the same way.

If you or your spouse are still actively working and covered through an employer or union health plan, the timing of Medicare Part B can depend on your particular coverage situation.

Before delaying Medicare, dropping employer coverage or making other changes, make sure you understand how your existing coverage coordinates with Medicare.

A mistake involving Medicare enrollment timing can be difficult to undo.

If you’re approaching retirement, this is an excellent time to start asking questions—even if you aren’t ready to enroll yet.

Already Have Medicare?

Medicare isn’t necessarily a “choose it once and forget about it” decision.

Medicare Advantage and Part D plans can make changes from one plan year to the next, including changes involving premiums, covered prescriptions, pharmacy networks, provider networks and other plan features.

Medicare’s Annual Open Enrollment Period runs from October 15 through December 7 each year.

That doesn’t automatically mean you need to change plans.

Sometimes the best outcome of a review is finding out that your current coverage still makes sense.

What If I Already Have a Medicare Supplement Plan?

Medicare Supplement coverage works differently from Medicare Advantage and Part D coverage.

Your Medigap Open Enrollment Period is generally a one-time six-month period beginning when you are age 65 or older and first enrolled in Medicare Part B. It does not repeat every fall.

Outside of an applicable guaranteed-issue situation, changing Medicare Supplement policies may involve medical underwriting.

Missouri residents may also have additional rights under Missouri’s Medicare Supplement Anniversary Rule.

If your Medicare Supplement premium has increased, it can make sense to understand your options before cancelling your existing policy.

How TCG Insurance Solutions Can Help

As an independent insurance agency, TCG Insurance Solutions can help you:

• Understand how Medicare Parts A, B, C and D fit together

• Compare Medicare Supplement options from insurance companies we represent

• Understand the differences between Plan G and Plan N

• Review Medicare Advantage and Part D options available through the organizations we represent

• Think through the transition from employer coverage to Medicare

• Review existing Medicare coverage when circumstances or plan benefits change

• Understand your options before making an enrollment decision

There is no obligation to enroll in a plan simply because we have a conversation.

My goal is to help you understand the information well enough to make a decision you’re comfortable with.

Have a Medicare Question?

Sometimes you don’t need a full appointment.

You just need an answer to one question.

If there is one Medicare question I can answer for you, use the form below and tell me what’s on your mind.

Whether you’re turning 65, retiring, comparing Medicare Supplement plans, reviewing prescription coverage or trying to understand something you’ve received from Medicare or your insurance company, I’m happy to help you sort through it.

Paul Carrigan
TCG Insurance Solutions
913-390-3220

[Insert Ask a Medicare Question Form]

By submitting this form, you authorize TCG Insurance Solutions to contact you using the information you provided solely for the purpose of responding to your question or inquiry. Your information will not be used for unrelated marketing purposes or sold to third parties. You are under no obligation to purchase any product or service.

Official Medicare Resources

For official Medicare information, coverage information and plan comparison tools, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).

TCG Insurance Solutions is not connected with or endorsed by the U.S. government or the federal Medicare program.

Medicare Advantage and Part D Disclosure

IMPORTANT: Replace the bracketed information below with your current organization and product counts before publishing.

We do not offer every plan available in your area. Currently we represent [NUMBER] organizations which offer [NUMBER] products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

 

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