Mbsm Solutions, LLC

Need Medigap, Medicare Advantage, Prescription Drugs, Dental, Or Vision Coverage?

Medicare Advantage (Part C)

Medicare Advantage (MA), also known as Medicare Part C, combines Part A and Part B and is offered by Medicare-Approved private insurance companies. To meet customers preferences and needs, carriers offer many plans varying design and pricing of:
There are many types of MA plans, but HMO and PPO are dominant. A popular feature is the Medicare Advantage with Prescription Drugs coverage (MAPD). To enroll in an MA plan, you must have Part A and Part B, and live in the Plan service area.

Part C Premium

The Part C premium varies by Plan and it depends on how the insurance company redesign the cost sharing, the benefits added, the In-and-Out-of Network cost, etc.

Medicare Prescription Drugs (Part D)
This program offers prescription drug coverage through private insurers approved by CMS. You can have coverage through a standalone plan (PDP) or through and MAPD plan. You must have Medicare Part A and / or Part B to enroll in Part D.

Part D Premium

The Part D monthly premium varies by plan and higher-income consumers may pay more. Similar to Part B, a beneficiary will pay an additional Part D premium based on the Income Related Monthly Adjustment Amount (IRMAA). 

Part D Deductible and Coinsurance

The deductible under the standard benefit for 2024 is $545 ($505 in 2023). Plan can design the PDP coverage to lower or eliminate the deductible but cannot charge a deductible more than this amount. For coinsurance there are 3 cost phases to consider:

Premium and non-covered drugs do not count toward TrOOP.

Part D Late Enrollment Penalty

You may owe a late enrollment penalty if, for any continuous period of 63 days or more after your Initial Enrollment Period is over, you go without one of these:

In general, you’ll have to pay this penalty for as long as you have a Medicare drug plan. The penalty is 1% of the national base beneficiary premium times the number of months you stayed without acceptable prescription drug coverage. For 2024, the national base beneficiary premium is $34.70