The importance of additional coverage

Original Medicare may leave you with some unpredictable out-of-pocket medical costs due to gaps in the coverage it offers.

Reliance Medicare Helpline offers plans from Aetna, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Cigna, Devoted, Freedom Health, Healthy Blue, Humana, Optimum HealthCare, Simply, United Healthcare, Wellcare, and WellPoint.

Gaps in Original Medicare

Here we list some of the out-of-pocket costs you may have to pay when you only have Original Medicare Parts A and B.

Prescription drugs
Dental
Vision
Hearing Aids

Understanding different plan types and how they work with your Original Medicare

There are a variety of private insurance plans that may help cover additional benefits or health needs that you have.

Stand-alone Prescription Drug Plans (Part D)

These plans help cover the costs of prescription drugs, so generally you won’t be responsible for 100% of the cost of covered prescriptions.

Medicare Supplement Plans

Also known as Medigap insurance, these plans help pay your out-of-pocket costs for Original Medicare covered medical services.

All-in-one Medicare Advantage Prescription Drug Plans

Medicare Advantage Prescription Drug plans combine all the benefits of Original Medicare Parts A and B and often add benefit options like Part D Prescription Drug coverage. They may also include some routine dental and vision coverage, and other additional benefits, all for a single monthly plan premium. You must continue to pay your Part B premium.

What's the difference: Medicare Advantage vs. Medicare Supplement

Medicare Advantage (Part C)

Medicare Advantage plans combine all the benefits of Original Medicare Parts A and B, and may include your Part D Prescription Drug coverage built right in. Plus, some plans will include routine dental and vision coverage, and other additional benefits, all for a monthly plan premium.

Do I keep my Part A and B coverage? Your Medicare Advantage plan will replace your Original Medicare Part A & Part B coverage, but you won’t lose a single benefit. In fact, you may get more. That’s because rather than pay your medical bills directly, the federal government contracts with private insurance companies to administer your plan.
How does the plan work to lower my out-of-pocket costs? Insurance companies compete for your business with affordable premiums and added benefits. The cost of care will be determined by your plan, and you may no longer be responsible for some out–of–pocket costs outlined by Original Medicare except for your monthly Part B premium. All Medicare Advantage plans include a maximum out of pocket limit which caps your annual out-of-pocket costs, so you'll never be charged more than this total amount for covered care each year.
Will I get access to additional coverage and additional benefits? Prescription drug, routine dental, vision, and hearing aid coverage are included with some Medicare Advantage plans. Check that the plan you want to enroll in includes this coverage.
Will I get to keep my doctor, and will I need a referral to see a specialist? To help manage costs, Medicare Advantage plans usually enter into contracts with a network of doctors and hospitals. That means you’ll generally pay less when you receive care from doctors and specialists who accept your plan. Some plans have large networks of approved doctors and hospitals so be sure to check yours are covered on the plan before you enroll. If you choose an HMO plan you may need a referral to use an in-network specialist, but generally referrals should not be required on PPO plans.
What monthly plan premium will I pay? Medicare Advantage plans generally have a lower premium than Medicare Supplement plans. Search for plans in your area to see available premiums.
When can I enroll? You can enroll in a new Medicare Advantage plan when you are initially eligible for Original Medicare—during your Initial Enrollment Period. You can also enroll in a new Medicare Advantage plan during the Annual Enrollment Period from October 15 to December 7 each year.
Can I change my plan later? If you want to switch to a different Medicare Advantage or Prescription Drug plan, you’ll be able to make that change during the Medicare Advantage Annual Enrollment period each year from October 15 to December 7. You can also change your Medicare Advantage Plan during the Medicare Advantage Open Enrollment Period from January 1st to March 31st. Please note that you cannot enroll for the first time during Open Enrollment period but you may during Annual Enrollment. Outside of those windows, you’ll need to have a qualifying life event to make a change.
Why would I choose a Medicare Advantage Prescription Drug Plan? Medicare Advantage Prescription Drug plans may be ideal for people who want an all-in-one plan that will cover their health and prescription needs in one. There are many Medicare Advantage Prescription Drug plans to choose from so enrollees can ensure they choose the one that covers all the added benefits and services they need to help maintain their health and stay within their budget.
Why wouldn’t I choose Medicare Advantage? Medicare Advantage plans rely on networks of approved doctors and hospitals to keep costs affordable and provide additional benefits. If your doctor is not in your plan’s network of providers, you may have higher costs. Your out-of-pocket costs may be lower if you receive care from in-network providers.

Medicare Supplement Insurance Plans (Medigap)

Medicare Supplement Insurance plans are standardized. They are labeled by letters (A-N). All Health Insurance companies must offer the same basic coverage for each plan. Companies compete for your business based on the monthly premium and other additional benefits beyond this base requirement. Medicare Supplement plans cannot be combined with a Medicare Advantage plan. These plans are separate, and you cannot be enrolled in both at the same time.

Do I keep my Part A and B coverage? Yes. You keep your Part A and B coverage with Original Medicare. Your Medicare supplement plan gets added on to help pay out of pocket costs for covered medical services.
How does the plan work to lower my out-of-pocket costs? MedSupp helps pay out-of-pocket costs not paid by Original Medicare (Parts A and B), like your part A deductibles and co-insurance. Typically, the higher the plan premium the lower your out- of-pocket "usage" charges will be. With some plans you can offset your monthly premium with a deductible that gets met before the plan covers the rest of your original Medicare expenses.
Will I get access to additional coverage and additional benefits? Medicare Supplement plans don’t typically cover prescription drugs or dental, vision, and hearing care. You won’t usually get additional benefits or services with these plans.
Will I get to keep my doctor, and will I need a referral to see a specialist? There are no network restrictions with a Medicare Supplement plan. You may visit any Doctor or hospital of your choosing as long as they accept Medicare patients. You can see specialists without referrals.
What monthly plan premium will I pay? The cost of your premium depends on the plan you choose. Your age, location, sex, and other items may be a factor as well. You must continue to pay your Original Medicare Part B premium as well.
When can I enroll? Medicare Supplement Plans are sold year-round. You can apply to buy a Medicare supplement insurance plan any time after you turn 65 and join Medicare Part B. There is no need for a special enrollment period. In many cases, however, pricing will be more favorable if you purchase a plan during your Medigap Open Enrollment Period. This period lasts 6 months after you enroll in Part B.
Can I change my plan later? You can switch or cancel your Medicare Supplement plan at any time for any reason. In some instances, you may be required to go through underwriting for your new Medicare Supplement Insurance plan if you are outside a guaranteed issue right.
Why would I choose this plan? These plans make your costs more predictable when choosing to receive your Parts A&B coverage through Original Medicare. They are great for people who prefer to steadily budget higher premium costs instead of paying each time they use their plan. These plans are also nice for people who want the flexibility to choose any doctor, hospital, or facility they want to use and are able to afford a higher premium in exchange for this flexibility.