Page 25 - North Haven Magazine Issue 39 Summer 2025

Medicare Insurance Questions?

203-239-4044

NICK CASELLA

• Network restrictions: Most are HMOs or PPOs, so you often must use a network of doctors and hospitals.
• Out-of-pocket limit: MA plans have an annual cap on out-of-pocket spending, which Original Medicare does not.

What Are Medicare Supplement Plans (Medigap)?
Medigap policies are add-on plans sold by private insurers that help pay for costs not covered by Original Medicare, such
as copayments, coinsurance, and deductibles.

Key Features:
• Works with Original Medicare: You keep Parts A and B, and the Medigap plan fills in the “gaps.”
• No network restrictions: You can see any doctor or hospital that accepts Medicare nationwide.
• No extra benefits: Generally doesn’t include Part D or extras like dental or vision.
• Higher monthly premiums: But you may have little to no out-of-pocket costs when you get care.
• Predictable costs: Helps budget healthcare spending with fewer surprises.

Coverage Type Medicare Advantage (Part C) Medigap(supplement)

Primary Coverage Replaces Original Medicare Works with Original Medicare
Doctor Choice Network-based (HMO/PPO) Any provider accepting Medicare

Prescription Drugs Often included Must buy separately
Additional Benefits Vision, dental, hearing, etc. Rarely offered
Monthly Premiums Low or $0 Higher
Out-of-Pocket Costs Copays & coinsurance Low to none

Out-of-Pocket Limit Yes No (but gaps are covered)

Final Thoughts
While the above info is helpful, the process can still be overwhelming. Choosing between a Medicare Advan-
tage Plan and a Medicare Supplement Plan depends on your health needs, lifestyle, and financial situation.
Before making a decision, compare plans in your area, evaluate your medical needs, and consider speaking
with a licensed Medicare Insurance agent.

WE MAKE MEDICARE INSURANCE SIMPLE! CALL US TODAY 203-239-4044
Health Insurance Associates, LLP • 250 State St. UNIT F1 • North Haven

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