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Medicare Advantage vs. Medicare Supplement (MediGap) Which Is Best?

Fri, 11 Dec 2020 13:19:19 GMT

Choosing between enrolling in a Medicare Advantage plan or buying a Medicare Supplement (i.e. MediGap) policy can be confusing for many Medicare beneficiaries. Although the basics of Medicare are relatively easy to grasp, the less obvious specifics that lie beneath the surface of each option can be more daunting, frequently misunderstood, and often misrepresented- which can lead to a misguided, and sometimes irreversible, decision made by the beneficiary. The purpose of this article is to provide a straightforward pros and cons evaluation of each of these options, which I believe will help you to make a more informed decision regarding your Medicare coverage.

The MediGap (Medicare Supplement) Option:

Original Medicare (i.e. Medicare Part A and Part B alone) is a “fee for service” health insurance plan. Therefore, Medicare beneficiaries are required to pay copayments and deductibles only if they utilize a “Medicare-covered” medical service. Following are examples of costs left behind after Original Medicare pays that the beneficiary is responsible for:

Hospital Admission: $1,484 for each benefit period (1-60 days).
Physician visits: copayment = 20% of the “Medicare-allowed” amount (i.e. average of $40 for a primary care visit and $70 for a specialist visit).
Out-patient Surgery and DME Supplies: copayment = 20% of the “Medicare-allowed” amount.
Nursing Home: Medicare will cover days 1-20 at no cost (if all Medicare coverage requirements are met), then beneficiary is required to pay $185.50 per day (days 21-100). There is no Medicare coverage after day 100.

A Medicare Supplemental (MediGap) policy is designed to pay for most all copayments left behind by Original Medicare. A MediGap policy, however, will only cover medical services that are first covered by Medicare. If Medicare does not cover the medical service, the MediGap supplement plan will also not cover it.

There a several different types of Medigap policies, which have varying levels of coverage. These options are summarized below:

Note: “Plan F” is no longer sold new Medicare beneficiaries.

As with any Medicare option, there are pros and cons you should consider before purchasing a MediGap policy.

Pros :

Any doctor (nationwide) who accepts Medicare as payment will also accept a MediGap policy as secondary coverage. It makes no difference what company the MediGap policy is purchased from. Also, all MediGap policies that have the same plan name type (i.e. G,N,D, etc) must provide “identical” coverage by law. In order words, Plan G purchased from Company X must be the very same as Plan G purchased from Company Y.
No referral is required to see any physician who accept Medicare.
Most copayments left by Original Medicare are completely covered by a MediGap policy. Depending on the MediGap plan selected, the beneficiary may still be responsible for part of the bill.

Cons:

MediGap policies typically cost $75 to $250 per month (depending on the type of plan purchase and the company the plan is purchased from.
If a MediGap policy is purchased, a typical monthly bill will be:

Part B Premium: $148.50

Prescription Drug Plan: $18

MediGap Supplement: $120

Total monthly bill: $285.00 (price varies) or about $3,400 per year.

** if a Dental/Vision plan is purchased, it may cost an additional $40 to $100 per month

3. You must pay the monthly premiums every month- even if you do not use any Medical services.

4. A prescription drug plan must also be purchased (average cost = $13 to $40 per month).

5. Additional benefits such as dental, vision and transportation coverage are generally not provided by Medicare or by most MediGap policies.

6, As the beneficiary gets older, the premium cost for their MediGap policy will continue to rise.

The Medicare Advantage (MAPD) Option:

The Medicare Advantage (MAPD) option has become increasingly popular in recent years due to its low cost and the inclusion of additional ancillary benefits. Medicare Advantage plans combine Medicare Part A + Part B + Part D all into one package, which is referred to as Part C (i.e. also called Medicare Advantage or MAPD). MAPD plans are private companies who contract with Medicare to provide Medicare services to beneficiaries who choose to enroll in one of their plans. By law, MAPD plans must provide services that are at least equivalent to services offered by Original Medicare. Unlike Original Medicare, however, MAPD plans also provide additional benefits such as dental, vision, and free gym memberships. MAPD plans are offered by many different companies (such as Humana, Aetna, WellCare, United Health Care, and others), who compete against each other trying to entice beneficiaries to enroll with their company. Company A may be more competitive than Company C because they offer a better dental package, while Company A may be more enticing than Company C to some because Company A offers transportation services and Company C does not. Before choosing to enroll in an MAPD plan, there are many factors you should consider.

A few of these factors include:

Are your doctors in network with the plan?
Are all medications you take covered by the plan?
Does the plan offer out of network coverage?

There are many more important factors to consider but are too numerous to be adequately covered in this article. See the article “Factors to Consider before Enrolling is a Medicare Advantage Plan” for a more in-depth discussion on this topic.

Pros and Cons to consider prior to enrolling in a Medicare Advantage plan include:

Pros:

Medicare Advantage (MAPD) plans (referred to as Medicare Part C) have low monthly premium costs ($0.00 monthly premium in many cases).
MAPD combines the benefits of Part A, Part B and Part D to provide all Medicare and Prescription drug benefits into one plan. No need to purchase a separate prescription drug, dental or vision plan.
Copayments are predictable and cannot exceed a stated yearly amount.
No out-of-pocket costs unless a Medicare-covered service is utilized by the beneficiary.
Additional benefits, including dental and vision coverage, ability to order OTC items at no additional cost, free gym memberships are often provided.
Some MAPD plans provide a “Part B Buy-Down” benefit of $30 to $70 to help pay our Part B monthly premium.
Coverage provided by MAPD plans must be equal or better than Original Medicare.

Cons:

Provider networks are limited. Not all physicians accept every MAPD plan. it is important to verify that your physicians, hospitals and other health care providers are in the plan’s network before enrolling.
HMO plans do not provide “out-of-network” coverage (unless in emergency situations). PPO plans, and some HMO-POS and PFFS plans do provide out-of-network coverage (but it is important to check ahead of time before enrolling).
Typical “out-or-pocket” copayments with MAPD plans are:
Hospitalization: $300 per day for days 1-6
Physician visits: Primary Care MD: $0-$10; Specialist MD visit: $20 -$50
ER visit: $90
Out-patient Surgery: $250-$350
Ambulance: $250-$280

Keep in mind, it is possible to cover these copayments with a Hospital Indemnity policy for a relatively low monthly cost premium cost.

It is always best to discuss your options with a knowledgeable insurance agent before deciding which way to go. If a wrong decision is made, you may not be able to correct it until the next year, and in some cases, the “bad decision” may not be reversible.

Important Factors To Consider When Choosing A Medicare Advantage Plan

Fri, 11 Dec 2020 13:19:19 GMT

Medicare Advantage (MAPD) combines Medicare Parts A, B and D (prescription drug coverage) together into one plan, referred to as Part C. These plans have become increasingly popular over the past decade due to the inclusion of many benefits not provided by Original Medicare (Part A + Part B), including dental, vision, transportation, ability to order over-the-counter products and some plans even help beneficiaries for their monthly Part B premium. These plans also provide financial protection by limiting the out-of-pocket costs a beneficiary is required to pay each year for Medicare services.

Enrollment in Medicare Advantage has almost doubled over the past decade. In 2019, one-third (36%) of all Medicare beneficiaries (i.e. 22 million people) were enrolled in a Medicare Advantage plan. Between 2018 and 2019, total Medicare Advantage enrollment grew by about 1.6 million beneficiaries, or 8 percent. The Congressional Budget Office (CBO) projects that the percentage of beneficiaries enrolled in a Medicare Advantage Plan will rise to about 47% by 2029.

In total for 2021, there are 3.550 different Medicare Advantage plans available nationwide for individuals to enroll in. This represents a 13% increase (402 more plans) compared 2020. This is a good thing for Medicare beneficiaries, because each different plan offers a slightly different combination of benefits- allowing consumers to the leverage to shop around for the plan that best fits their lifestyle and health care needs.

While a Medicare Advantage plan can be a great option for Medicare beneficiaries, enrolling in the wrong plan can potentially cause problems. It is therefore necessary to carefully evaluate the plan’s specifics plan before enrolling. Following is a checklist of things that you should consider prior to choosing a Medicare Advantage plan:

Do all your doctors accept the plan?

Every MAPD plan has a network of physicians, hospitals and other health care providers. It is important to make sure that all providers you routinely use are in the plan’s network.

Do you typically have multiple specialist physician appointments each month?

Most MAPD plans have a $0 copay for primary care physicians but can charge up to $50 per visit to see a specialist.
If you typically see several specialists per month, you may want to consider an MAPD plan that has a lower specialist copayment.
Some MAPD plans charge as low as $15 or $20 to see a specialist.

Are all your medications covered by the plan?

It is easy to view the cost of your medications by using the “Medicare.gov” site. Because medication formularies and prices vary greatly from plan to plan, take time to compare plans to determine which provide the best deal.

Does the MAPD plan have a yearly deductible for medications?

Some plans have a yearly prescription drug deductible for certain medications (usually for tiers 3-5 or may include tiers 2-5).
The prescription drug deductible can range from $0 to $445 per year.
Be sure to access the “Medicare.gov” website to evaluate the cost of your medications each month, and to determine if a yearly deductible will apply.

Do you need transportation services?

Some plans provide a transportation benefit which allows beneficiaries to call the company to request transportation to and from a scheduled medical appointment.

Do you need a good dental, vision or hearing coverage plan?

Most Medicare Advantage plans provide some level of dental, vision and hearing coverage, but the degree of coverage each provides varies greatly. Examples of dental coverage provided by MAPD plans:

Some plans provide coverage for routine check-ups but charge high copayments if comprehensive work of any kind is performed (be sure to ask what dental procedures are covered and how much out-of-pocket cost is required upfront).
Some plans allow for a predetermined amount of coverage for any dental services (from any dental provider) but require that you pay for the service(s) upfront and then file for reimbursement.
Some plans allow for a predetermined amount of coverage at a “network” dental provider (which may or may not include the dentist you are currently using). The amount of allowed coverage varies from $750 to $1500 per year and is billed directly to the MAPD company by the provider. For beneficiaries with Medicare and Medicaid coverage, as much as $2,000 to $4,000 per year for comprehensive dental coverage is available.
Some plans do not provide dental coverage but can be purchased for a monthly premium.

Examples of vision coverage provided by MAPD plans:

Most plan provide for a $0 cost vision exam each year.
Most plans have a network of vision providers that you must use.
Many plans provide $100 to $300 per year to purchase glasses or contacts. For beneficiaries with Medicare and Medicaid coverage, plans can provide up to $500 per year of eyeglasses or contacts.
Some plans provide a set amount of money for eyeglasses or contacts but require that you make the out-of-pocket purchase and then send in the receipt for reimbursement.

Do you need help paying for your Part B monthly premium?

Some MAPD plans provide $30 to $70 per month to assist paying for your Part B monthly premium (i.e. typically $148.50 per month). This benefit is referred to the “Part B Buy Down”.
MAPD plans that offer this benefit will pay the predetermined amount of your Part B premium directly to CMS, which decreases the amount you are responsible for.
For example, if the “Part B Buy Down” benefit is $50 per month, the MAPD plan will pay $50 of your Part B premium and you will pay only $98.50 per month ($148.50 - $50 = $98.50). The extra $50 will remain in your checking account.

Are you aware of the difference between an HMO, PPO, PFFS, and SNP MAPD plans?

There are different types of Medicare Advantage Plans:
Health Maintenance Organization (HMO) Plans
Preferred Provider Organization (PPO) Plans
Private Fee-for-Service (PFFS) Plans
Special Needs Plans (SNPs)
Medical Savings Account (MSA) Plans

It is very important to understand how each plan type works before deciding to enroll. If you make a wrong decision, it may not be possible to correct it until the next year.

Health Maintenance Organization (HMO):

An HMO Medicare Advantage Plan generally provides health care coverage from doctors, other health care providers, or hospitals in the plan’s network (except emergency care, out-of-area urgent care, or out-of-area dialysis). A network is a group of doctors, hospitals, and medical facilities that contract with a plan to provide services. Most HMOs also require you to get a referral from your primary care doctor for specialist care, so that your care is coordinated.

Can I get my health care from any doctor, other health care provider, or hospital?

No. You generally must get your care and services from doctors, other health care providers, or hospitals in the plan’s network, (except for emergency care, out-of-area urgent care, or temporary out-of-area dialysis, which is covered whether it’s provided in the plan’s network or outside the plan’s network). Therefore, if you choose an HMO MAPD plan, you may be denied service from out of network physicians and medical facilities.

HMO Point-of-Service (HMO-POS):

An HMO-POS plan is like an HMO plan with the exception that you can possibly get health care outside of the plan’s network. However, you will likely have to pay a higher copayment of coinsurance. It’s important that you follow the plan’s rules, like getting prior approval for a certain service when needed. In most cases, you need to choose a primary care doctor. Certain services, like yearly screening mammograms, don’t require a referral.

Preferred Provider Organization (PPO):

A Medicare Advantage Plan that has a network of doctors, specialists, hospitals, and other health care providers you can use, but you can also use out-of-network providers for covered services, usually at a higher cost.

Can I get my health care from any doctor, other health care provider, or hospital?

Yes. PPO plans have network doctors, specialists, hospitals, and other health care providers you can use, but you can also use out-of-network providers for covered services, usually for a higher cost. You’re always covered for emergency and urgent care. If you choose to use services from an out-of-network provider, it is important contact the physician or plan administrator in advance to ensure that the services are medically necessary and that your plan will cover them.

Private Fee-for-Service (PFFS):

With a PFFS plan, you can go to any Medicare-approved doctor, other health care provider, or hospital that accepts the plan’s payment terms and agrees to treat you. If you join a PFFS plan that has a network, you can also see any of the network providers who have agreed to always treat plan members. You can also choose an out-of-network doctor, hospital, or other provider, who accepts the plan’s terms, but you may pay more. Before you get any services, ask your doctor or hospital if they can contact the plan for payment information and accept the plan’s payment terms. If you need emergency care, it’s covered whether the provider accepts the plan’s payment terms or not.

By agreeing to accept the a PFFS plan, the provider must agree to follow the plan’s terms and conditions for payment and bill the plan for the services they provide for you. However, it is important to understand that an out-of-network provider has the option to decide at each subsequent visit whether to accept the PFFS plan’s terms of payment for their medical services. If requested by the provider, you may have to pay an additional amount (up to 15% more) if the PFFS plan allows providers to “balance bill” (i.e. when a provider bills you for the difference between the provider’s charge and the amount allowed by the plan).

Do PFFS plans cover prescription drugs?

Sometimes. If you want Medicare prescription drug coverage, and it’s offered by the PFFS plan you enroll in, you must get your drug coverage from that plan.

If your PFFS plan doesn’t offer drug coverage, you can join a separate Medicare drug plan if you choose to do so.

Special Needs Plans (SNP):

A Special Needs Plan (SNP) provides benefits and services to people with specific diseases, certain health care needs, or limited incomes. SNPs tailor their benefits, provider choices, and list of covered drugs (formularies) to best meet the specific needs of the groups they serve. SNPs can be either an HMO or PPO plan, and cover the same Medicare Part A and Part B benefits that all Medicare Advantage Plans cover. However, SNPs might also cover extra services tailored to the special groups they serve. For example, if you have a severe or chronic condition, like cancer or chronic heart failure and you require a hospital stay, a SNP may cover extra days in the hospital.

Who can Quality for a SNP plan?

You may qualify for an SNP if you live in the plan’s service area and meet one of these requirements:

If you have one or more of the chronic illnesses listed below, you may qualify for a Chronic Condition SNP (also referred to as a C-SNP):
Chronic alcohol and other dependence
Autoimmune disorders
Cancer (excluding pre-cancer conditions)
Cardiovascular disorders
Chronic heart failure
Diabetes mellitus
End-stage liver disease
End-Stage Renal Disease (ESRD) requiring dialysis (any mode of dialysis)
Severe hematologic disorders
HIV/AIDS
Chronic lung disorders
Chronic and disabling mental health conditions
Neurologic disorders
Stroke
I you’re eligible for both Medicare and Medicaid (also called a Dual Eligible SNP or D-SNP).
Each SNP limits its membership to people in one of these groups, or a subset of one of these groups. You can only stay enrolled in an SNP if you continue to meet the special conditions that the plan serves.

Can I get my health care from any doctor, other health care provider, or hospital?

HMO and PPO SNP plans follow the same provider network rules as other HMO and PPO plans. However, Chronic Condition SNP plans typically have more physicians specialized in treating certain chronic health conditions included in their network.

“Original” Medicare: What it Covers, What It Costs, And Permanent Monetary Penalties Associated With “Late Enrollment”

Fri, 11 Dec 2020 13:19:19 GMT

Medicare Part A:

What is covered by Medicare Part A?

Medicare Part A is typically known as “Hospital Insurance”. However, this term is misleading because you don’t have to be hospitalized to receive Part A coverage.
Medicare Part A provides coverage for:
Nursing care received in the hospital, nursing home or rehab center.
A semi-private room in a hospital or nursing facility
Services provided in the hospital or nursing facility; including lab tests, prescriptions drugs, medical appliances and supplies, and rehabilitation therapy.
All services provided by a home health agency or hospice program

Do I have to pay a monthly premium?

If you or your spouse earned at least 40 work credits (equivalent to about 10 years of full-time employment) during your lifetime and paid Medicare taxes (i.e. FICA), you will not be required to pay a monthly Medicare Part A premium.
If you or your spouse earned 30-39 work credits during your lifetime, you will be required to pay a monthly Part A premium of $259.
If you earned less than 30 work credits, you have the option to purchase Part A coverage for $471 per month

Is there a penalty for not purchasing Medicare Part A?

Yes. If you do not qualify for “premium-free” Part A coverage, and choose not to purchase it when you’re first eligible (i.e. usually at age 65), you may be charged a 10% monthly “late” penalty if you decide to enroll at a later time. You will be required to pay the higher premium for twice the number of years you could have had Part A coverage – but did not sign up.

What “coinsurance” costs are associated with Medicare Part A?

You pay a $1,484 deductible for each benefit period . After you pay this deductible, Medicare will pay 100% of your hospital cost for the first 60 days (i.e. equivalent to one benefit period).
If you remain hospitalized past 60 days , you will pay a $371 coinsurance for days 61-90.
For days 91 and beyond , you are allowed draw on your 60 “Lifetime Reserve Days”. For each lifetime reserve day used, you will pay a $742 coinsurance . When these 60 lifetime reserve days are used up, they cannot be replaced.
If continued hospitalization is required, all remaining costs will be the responsibility of the beneficiary.
When you have been out of the hospital for at least 60 days, a new Benefit period begins, and the cycle repeats itself. There is no limit to the number of benefit periods a beneficiary can have.

Home Health Care:

$0 cost for home health nursing services
You will pay a 20% coinsurance of the Medicare-approved amount for Durable Medical Equipment (DME).

Hospice:

$0 cost for hospice care
You man need to pay a copayment of no more than $5 for each prescription drug and other similar products for pain relief and symptom control while you’re at home.
You may need to pay 5% of the Medicare-approved amount for inpatient respite care.
Medicare doesn’t cover room and board when you get hospice care in your home or another facility where you live (like a nursing home).

Skilled nursing facility stay:

Days 1-20: $0 for each benefit period
Days 21-100: $185.50 coinsurance per day for each benefit period
Days 101 and beyond: Beneficiary is responsible for all costs.

Medicare Part B:

What is covered by Medicare Part B?

You pay a 20% copayment for the Medicare-approved amount for most doctor services including:

Most doctor services while you’re in the hospital), outpatient therapy and Durable Medical Equipment (DME).
Services received at a Hospital outpatient clinic or department
“Partial” hospitalization (also called Hospital Observation Care) provided in a hospital outpatient setting or community mental health center.
Outpatient hospital services.

Do I have to pay a monthly premium?

Unless you qualify for one of the “Medicare Savings Programs” (see related blog article), you will be required to pay a monthly Part B premium (based on your income). For individuals making $88,000 or less ($176,000 or less if filing jointly), the Part B monthly premium is $148.50. The monthly premium will be higher for those making a higher income.
If you qualify for one of the “Medicare Savings Programs”, you will not be required to pay a Part B premium.

What “coinsurance” costs are associated with Medicare Part B?

You will pay a Part B deductible of $203 per year. After this deductible is met, you typically pay 20% of the Medicare-approved amount for:
Most doctor services
Outpatient therapy
Durable Medical Equipment (DME)
Clinical laboratory services: You pay $0 for Medicare-approved services.
Outpatient Mental Health Services:
You usually pay 20% of the Medicare-approved amount for the doctor or other health care provider’s services.
In addition to the amount you pay the doctor, you’ll also usually pay the hospital a copayment for each service you get in a hospital outpatient setting- except for certain preventative services that don’t have a copayment charge.

Is there a penalty for not purchasing Medicare Part B?

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty . This penalty will apply for as long as you have Part B coverage .
Be sure to ask your employer if your healthcare insurance plan is “credible” by Medicare standards. If it is not, you will be subject to a “late-enrollment” penalty. Your employer is required by law to provide this information to you.
For each full 12-month period that you could have had Part B , but chose not to sign up for it, you’re monthly Part B premium will increase by 10% over the standard premium amount. For example, if your normal Part B premium is $148.50 per month, and you chose not to enroll in Part B until age 67 (24 months later). Your Part B monthly penalty will be $29.70 (for 2021), and your monthly Part B premium would be $178.20.
This penalty can be avoided by proving that you had “credible” health insurance coverage (through your or your spouse’s employment) after turning 65. CMS requires that certain forms be completed to prove “credible” coverage.

Medicare Part D:

What is covered by Medicare Part D?

Medicare Part D provides coverage for prescription drugs obtained from a retail or mail-order pharmacy.

Do I have to pay a monthly premium?

The monthly premium cost for a stand-alone Part D prescription drug plan will vary based on the company, degree of coverage and income level. If your income is $88.000 or less ($176,000 or less is filing your IRS tax return jointly), you will pay the typical plan cost. If your income is these levels, your Part D prescription drug coverage monthly premium will be higher. The cost of a “stand-alone” Part D prescription drug plan varies greatly depending on the degree of coverage it provides. However, a typical Part D plan usually cost $20 or less per month.

What “coinsurance” costs are associated with Medicare Part D?

Medicare Part D prescription drug plans are typically divided into 5 or 6 tier levels:
Tier 1: Preferred generic drugs (commonly used generic drugs)
Typically cost $0 to $3 per 30-day prescription
Tier 2 : Non-preferred generic drugs
Typically cost $7 to $11 per 30-day prescription
Tier 3: Preferred Brand drugs (lowest cost brand name drugs on the formulary)
Typically cost $38 to $47 per 30-day prescription
Tier 4: Non-Preferred Brand Name drugs (higher-priced brand name and generic drugs not in a “preferred” tier)
For most plans, the cost is 45 to 50% of the retail cost of the drug
Tier 5: Specialty drugs. These are the most expensive drugs on the formulary. They are typically used to treat complex conditions like cancer and multiple sclerosis. They can be generic or brand name.
For most plans, the cost is 25 to 33% of the retail cost for the drug
Tier 6: Select Care Drugs. These are generic drugs used to treat diabetes and high cholesterol.
Drugs in this tier typically cost $0-$5 per month.

Not all medications are covered by every Part D drug plan. Before enrolling, it is prudent to find out if all your medications will be paid for by the plan.

Is there a penalty for not purchasing Medicare Part D?

The Part D “late enrollment” penalty is an amount that is “ permanently ” added to your Medicare drug coverage (Part D) premium.
You may owe a late enrollment penalty if at any time after your “Initial Enrollment Period” (IEP) is over, there’s a period of 63 or more days in a row when you didn’t have Medicare drug coverage or “Credible” prescription drug coverage.
You will pay this Part D penalty for as long as you have Medicare drug coverage.
The amount of the Part D penalty depends on how long you went without “credible” prescription drug coverage. Medicare calculates the penalty by multiplying 1% of the “national base beneficiary premium” ($33.06 for 2021) times the number of full, uncovered months you didn’t have Part D or credible coverage.
Example: Mr. Jones is currently eligible for Medicare, and his Initial Enrollment Period (IEP) ended on May 31, 2017. She currently does not have prescription drug coverage. Mr. Jones waited until the Open Enrollment Period that ended December 7. 2019 to enroll in a Part D prescription drug plan- which became effective on January 1, 2020. Since Mr. Jones was without drug coverage from June 2017 to December 2019, his penalty is 31% (1% for each of the 31 months he did not have coverage) of $33.06 (the national base beneficiary premium for 2021), or $10.25 each month. Since the monthly penalty is always rounded to the nearest $0.10, he will pay $10.30 each month in addition to his plan’s monthly premium.

Here’s the math:

0.31 (31% penalty) x $33.06 (2021 based beneficiary premium) = $10.25

$10.25 rounded to the nearest $0.10 = $10.30

$10.30 = Mr. Jones’ monthly late enrollment penalty for 2021.

Since Mr. Jones’ actual Part D premium is $20 per month, he will pay $30.30 per month ($20 + $10.30 = $30.30) for his plan.
It is possible to avoid paying the Part D late enrollment penalty if you can prove that you did had “credible” Part D coverage during the contested time period. This will require the completion of a form provided by Medicare.

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Medicare Advantage vs. Medicare Supplement (MediGap) Which Is Best?

The MediGap (Medicare Supplement) Option:

The Medicare Advantage (MAPD) Option:

Important Factors To Consider When Choosing A Medicare Advantage Plan

Health Maintenance Organization (HMO):

Preferred Provider Organization (PPO):

Private Fee-for-Service (PFFS): ﻿

Special Needs Plans (SNP):

“Original” Medicare: What it Covers, What It Costs, And Permanent Monetary Penalties Associated With “Late Enrollment”

Medicare Part A: ﻿

Medicare Part B:

Medicare Part D:

Private Fee-for-Service (PFFS):

Medicare Part A: