Medigap – Keeping It Simple

Medicare is for people 65 years or older
People under age 65 with certain disabilities
People of any age with End-Stage Renal Disease (ERSD)
People of any age with End-Stage Renal disease (ESRD) (Permanent Kidney failure requiring dialysis or a kidney transplant

Just turning 65 and overwhelmed? Being bombarded in the mail? Your phone ringing off the hook? Don’t know who to trust or where to go? Do you know the difference between a Captive Agent and an Independent Broker and how they can help you with your Medicare Supplement needs? Take just a minute and read about the differences and then we will review some key elements to Medicare

What is a Captive Agent?

A Captive Agent works for one particular insurance carrier, such as BC/BS or Humana, etc. A Captive Agent cannot sell anything but that one carrier. When your policy renews after 12 months of coverage, that Captive Agent has no where else for you to go. They cannot shop for you a better rate because all they have is that one plan.

What is an Independent Agent or Broker?

Our Team at BeniPro Solutions, LLC agents, who watch the Medicare Market daily and who are always looking for the best value. We are Independent, meaning we are not employees of one carrier and we are free to pick and choose the best companies, the industry has to offer.   Our goal is pin point focused and that is to find the best value, for each and every client. Unlike Captive Agents who may turn you over to Customer Service after the sale, we at BeniPro Solutions are there for the long haul. We are there for you should you ever have a question or a problem. We are your advocate, your “go to” person, for all your Medicare questions and needs. There’s no need to go shopping when you have us. We do the shopping for you.

What is the difference between Medigap policies?

Medigap policies come in two varieties. A Medicare Supplement and a Medicare Advantage.
A Medicare Advantage plan, frequently called a “Part C”, depending on where you live, is very inexpensive or may cost nothing at all.
Why so cheap?
Because it works very much like a group plan. With a MA plan you do not have Medicare and a supplemental plan, you only have the one plan, through the insurance company.
You pay your premium and Medicare is combined with the insurance plan, as is your Part D coverage (prescriptions). It works very much like a group plan, in that you pay one flat premium, and then you pay co-pays at the time of service, up to an out of pocket maximum which can be quite large. If your healthy and you do not have to see many doctor’s, MA can save you money. But if you are a high utilizer, going often to the doctor, receiving frequent care, a MA plan can co-pay you “to death”, leaving you with a large out of pocket cost.

What is a Medicare Supplement?

A Medicare Supplement is a plan that you buy from an insurance company that will pay what original Medicare Part A & B don’t pay. (You must have Part A & Part B to purchase a Medicare Supplement). A Medicare Supplement will not cover Part D drug costs. With most Medicare Supplement plans there is no co-pays and when you see a physician, you usually do not owe anything and your out of pocket costs are greatly reduced, if not almost completely eliminated. Page 80 of your Medicare Supplement guide for 2018 shows you the Medigap plans available by letter name, A – N. Plan F and Plan G are by far the most popular. No matter what company you buy from, Plan F is Plan F. There is no difference between the plans. Only the premium is different from insurance company to insurance company.

What do I do about Prescriptions?

Original Medicare does not cover out-patient prescription drugs, nor does Medicare Supplements. Prescription drugs are covered under a Part D Prescription Drug Plan. This is an optional benefit offered to anyone on Medicare. A Medicare drug plan needs to be purchased when first eligible for Medicare and or a Supplement or you could be charged a late enrollment penalty for joining later, and will pay the penalty, translated into additional cost, throughout the time that you have the Part D plan.

Each company has its own formulary or list of drugs that it will cover and this list can change frequently. Should you need additional help with the high cost of drugs, see your Medicare & you guide for additional details, should you have limited income and resources.

When to buy?

Be sure to go on-line and download your free 2018 Medicare guide at for the most up to date Medicare information from the government.
The best time to buy, is during Open Enrollment, which lasts for 6 months and begins on the first day of the month in which you turn 65 or older and enroll in Medicare Part B.
During this open enrollment period, the insurance company cannot use medical underwriting. In other words, they can not turn you down or penalize you for any health condition that you may have.

Medigap policies are standardized

Every Medigap policy must follow federal and state laws designed to protect you, and they must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only a “standardized” policy identified in most states by letters A through D, F through G, and K through N.
All policies offer the same basic benefits, but some offer additional benefits, so you can choose which one meets your needs.
In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way.

What to do when the price goes up at renewal?

If you’re a customer of BeniPro Solutions, you ae on our radar! We know when your policy is renewing, and we have been watching the market for this very day! We will notify you ahead of time that your policy is renewing, and we are here to help. Should the renewal be more than you desire to pay, or we know of a great new product that we are sure you would like, we will notify you and let you take a look. If your happy where you are, then great, you can stay right there! We always have your back at BeniPro Solutions.

Who Can I Talk To?

For general Medicare information, you can call 1-800-Medicare or you can call BeniPro Solutions, Local # 770-904-1450 and Toll Free 866-604-8496, for answers to many of your Medicare Supplement questions.
We are not partial to any insurance carrier. We constantly search, read, investigate market trends and are on the hunt for the best value for our clients.
We don’t want to pay more than we must, so neither should you!