Medicare Advantage and Supplementary Plans
What is Medicare?
Medicare is health insurance for people 65 or older. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease). More than 66 million people in the U.S. get their health coverage from Medicare. The Centers for Medicare & Medicaid Services (CMS) is the federal agency that runs the Medicare Program. CMS is a branch of the Department of Health and Human Services. CMS also monitors Medicaid programs offered by each state.
In 2024, Medicare covered over 67.6 million people. Total expenditures in 2024 were just over $1.1 trillion. This money comes from the Medicare Trust Funds.
Visit Medicare.gov for additional information.
How does Medicare work?
Medicare consist of four different parts.
Hospital Insurance
Covers inpatient hospital stays, skilled nursing facility care, hospice services, and limited home health care. Most eligible beneficiaries do not pay a monthly premium
Medical Insurance
Covers doctor visits, outpatient services, preventive care, durable medical equipment, and medically necessary services. A monthly premium is required.
Medicare Advantage
Offered by private insurance companies as an alternative to Original Medicare. Combines Parts A and B and often includes prescription drug coverage along with additional benefits such as dental, vision, and hearing.
Prescription Drug Coverage
Helps cover the cost of prescription medications. Available as a standalone plan or included within a Medicare Advantage plan.
What is a Supplementary Plan?
Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private insurance company to help pay your share of out-of-pocket costs in Original Medicare, like copayments, coinsurance, and deductibles By filling these coverage gaps, a Medicare Supplement helps reduce out-of-pocket expenses, provides more predictable medical costs, and allows beneficiaries to see any doctor or hospital nationwide that accepts Medicare without needing referrals or network restrictions.
Every Medigap policy must follow federal and state laws designed to protect you. It’s important to watch out for illegal practices by insurance companies, and protect yourself when you’re shopping for a Medigap policy.
What isn't covered by Medigap?
Medigap doesn’t cover everything. Medigap plans generally don’t cover:
- Long-term care (like care in a nursing home)
- Vision or dental care
- Hearing aids
- Glasses
- Private-duty nursing
Note: You can enroll in a separate Medicare drug plan (Part D) if you want prescription drug coverage.
How can I receive those coverages?
NJSave Programs
NJSave is an online application to help low-income older adults and individuals with disabilities save money on Medicare premiums, prescription costs, and other living expenses. The plans include:
- PAAD- (Pharmaceutical assistance to the aged and disabled)
- QMB- (Qualified Medicare beneficiary)
- SLMB- (Specific Low-Income Medicare Beneficiary)
- QI- (Qualifying Individual)
Click here to see what you may qualify for.
Have a Question?
We can help. Our team will work with you to understand your goals, explore your options, and find the solution that fits your needs—without breaking the bank.