Medigap vs. Part D Chicago, Illinois

Medigap vs. Part D Chicago, Illinois
By James O'Neal

There are additional considerations when taking prescription medicines while elderly. Both Medicare Part D and Medicare Advantage plans include coverage for prescription medication. You should choose the plan that best suits your circumstances.

What is Medigap?

When Medicare doesn’t provide enough coverage, Medigap can provide the needed coverage. Medigap plans are not often offered for vision, hearing, long-term care, or in-home care. Only certain types of coverage, such as travel health insurance and frequent emergency medical treatment, can be accessed via these plans.


Medigap plan N, for example, covers foreign emergencies and hospitalizations, whereas emergency visits cost $50. Part B deductibles are covered by Medigap plan F, a more expensive plan covering the 20% portion of services Medicare does not pay for.

What is Part D?

Prescription drug coverage is provided under the Medicare Part D program. Medicare Part D Prescription Drug Plan options include a stand-alone Medicare Part D Prescription Drug Plan that works with Original Medicare and a Medicare Advantage Prescription Drug plan.


It is important to ensure that the Medicare Prescription Drug Plan (or the Medicare Advantage Prescription Drug Plan) you choose covers all of your prescriptions before you enroll.

For every Medicare Prescription Drug Plan, a formulary lists the drugs it covers, and many of these formularies may be accessed online. The formulary of a plan can be altered at any moment. When necessary, your plan will send you a notification.


Medigap vs. Part D Chicago, Illinois


  1. Diverse health problems

If you meet certain criteria, you may be able to enroll in a Special Needs Plan (SNP). You may qualify for an SNP if you suffer from certain medical conditions or are institutionalized or dual-eligible for Medicaid and Medicare.


  1. An impairment exists.

Having a disability under 65 and not being eligible for Medigap coverage? If so, you are unlikely to be able to apply for one. Under the law, Medigap coverage is not guaranteed for enrolls under 65 years old.

Even if you’re under 65, you can receive a Medicare Advantage plan if you’re qualified for Medicare, even if you don’t qualify for Medigap (as of 2021, even enrolled with ESRD can sign up for Medicare Advantage; this was not the case before 2021 unless the Advantage plan was an ESRD Special Needs Plan).


  1. Enrollment is low

Is your Medigap open enrollment period already over, and you’re only covered by Original Medicare? Insurance companies in most states can employ medical underwriting if you apply for Medigap after the original open enrollment period has expired. The cost of Medigap coverage may be prohibitive or impossible to obtain based on one’s health.


  1. Non-standard benefits

No, I’m not interested in extras like dental insurance or gym memberships. These are typically included with Medicare Advantage plans, but not Medigap.

The Medigap plans sold since 2006 do not cover prescription drugs. If you choose Original Medicare plus a Medigap plan, you will have to buy a Medicare Part D plan.


  1. Premiums

One major concern is the cost of the premium. “Zero-premium” Medicare Advantage plans can be found in many areas, but you’ll still owe Part B in 2022 (for most enrolled, the monthly fee is $170.10). For more differences, search for Medigap vs. Part D Chicago, Illinois.


Bottom Line!

Medicare Advantage and Original Medicare with supplemental insurance both work effectively. There is no right or wrong decision. Then again, there are several things to keep in mind. So, if you’ve any queries concerning Medigap vs. Part D Chicago, Illinois, you can reach out to us at O’Neal Insurance Group.