Resources for you

01

Medicare Advantage VS Medicare Supplement

In this video, we walk through the pros and cons of a Medicare Advantage plan and a Medicare Supplement Plan. Which plan is right for you? This video will help you focus in on what is most important in your situation. Medicare Supplement vs Medicare Advantage plan.

02

What can you do about Medicare Supplement increases?

In this video, Trevor and Brad discuss the inevitable rate increases that come with Medicare Supplements. They breakdown options and strategies for people to change coverage or apply for better rates with other insurance carriers. Here we focus on Medicare Supplements in Lexington, NC.

03

Annual Enrollment Period and FAQ's we get

In this video, Daniel and Brad review the big changes that come during each year's Annual Enrollment Period for Medicare (October 15th - Dec 7th). They also review why a local agent is so important, and frequently asked questions from clients. Here we focus on Medicare Advantage plans in Lexington, NC.

ARTICLES BY OUR TEAM

MEDICARE BASICS

Understanding the Basics of Medicare: Parts A, B, D, and More

By Daniel Leonard – Carolina Advantage (336) 705-3294

Navigating Medicare for the first time, or even revisiting it during the annual enrollment period, can feel overwhelming. As someone who helps people through this process every day, I want to give you a clear, straightforward overview of the basics: Medicare Parts A, B, and D, along with a quick look at Medicare Advantage (Part C) and Medicare Supplement plans and why they are important.

Medicare Part A – Hospital Insurance

Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services. Most people qualify for premium-free Part A if they or their spouse paid Medicare taxes while working for at least 10 years.

While Part A helps cover many hospital-related costs, it doesn’t cover everything. For example, there are big deductibles and other costs associated with Part A.

Medicare Part B – Medical Insurance

Part B covers outpatient services like doctor visits, preventive care, lab work, X-rays, durable medical equipment, and some home health services. Unlike Part A, Part B requires a monthly premium, which is based on your income. (Standard 2025 Part B Premium: $185/mo)

It’s important to enroll in Part B when you’re first eligible, or you could face late enrollment penalties. Also, just like Part A, there are deductibles and a 20% coinsurance for most services, with no cap.

Medicare Part D – Prescription Drug Coverage

Part D is your prescription drug coverage, offered through private insurance companies approved by Medicare. These plans vary by cost and formulary (the list of covered drugs), so it’s essential to choose one that fits your specific medication needs.

Even if you don’t take medications now, enrolling when you’re first eligible helps avoid a lifetime late enrollment penalty later.

Quick Look: Medicare Advantage (Part C)

Medicare Advantage plans, also known as Part C, are offered by private insurers and combine your Part A and B coverage into one plan. Many also include Part D drug coverage and extra benefits like vision, dental, hearing, fitness programs, and even transportation services.

These plans often come with lower premiums or even $0, but you’ll typically work within a network of providers. Each plan is different, so it’s important to talk to a local agent about your options.

Quick Look: Medicare Supplement Plans (Medigap)

Medicare Supplement Insurance, or Medigap, helps pay the out-of-pocket costs not covered by Original Medicare (Parts A and B), like deductibles, copays, and coinsurance. These plans offer more predictable out-of-pocket costs and allow you to see any provider that accepts Medicare—no networks!

However, Medigap plans do not include prescription drug coverage, so you’ll need a separate Part D plan if you go this route. Also, Medicare Supplement premiums will increase every year.

3 STEPS FOR NEW ENROLEES

If you are signing up for Medicare for the first time, understanding the process can make enrollment much easier. As local Medicare agents located in Lexington, NC, here are three important steps everyone enrolling into Medicare for the first time should take:

Step 1: Know When to Enroll
Your Initial Enrollment Period begins three months before your 65th birthday, includes your birthday month, and ends three months after. Missing this window could lead to late enrollment penalties or gaps in coverage (unless you have group coverage with more than 20 employees). If you are already receiving Social Security benefits, you may be automatically enrolled in Medicare Parts A and B the month you turn 65.

Step 2: Understand Your Coverage Options
Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). Many people also choose to add a Medicare Supplement plan and a Part D prescription drug plan to help with out-of-pocket costs. Another option is Medicare Advantage plans, which combine medical and drug coverage into one plan. Comparing your choices carefully can help you find coverage that fits your healthcare needs and budget.

Step 3: Get Help From a Licensed Medicare Agent
Medicare can feel confusing, especially for first-time enrollees. Working with a local agent can help you compare plans, understand costs, and avoid common mistakes. An experienced agent can guide you through the enrollment process and help ensure you select the right coverage for your situation.

SUPPLEMENT VS ADVANTAGE

The Two Main Coverage Options: Medicare Supplement vs. Medicare Advantage

Medicare Supplement (Medigap) + Part D (Prescriptions)

Medicare Supplement plans are designed to work alongside Original Medicare (Part A and Part B). These plans help pay for out-of-pocket costs like co-pays, coinsurance, and deductibles. There are several different Medigap plans (Plan G, Plan N..), each with varying coverage levels. The key benefit of Medigap is that you retain your freedom to choose any doctor or hospital that accepts Medicare, without needing to worry about networks or referrals. You must enroll into a separate prescription plan, Medicare Supplements do not include prescription coverage.

Pros

Cons

No networks when choosing providers

Predictable and low out of pocket costs ($283 annual max out of pocket)

Guaranteed renewability

More expensive option ($120-$175/mo)

Premiums increase annually

Does not include Dental/Vision or Prescriptions

Medicare Advantage (Part C)

Medicare Advantage plans, offered by private insurance companies, are another option to Original Medicare. These plans combine Parts A and B and usually include additional benefits like dental, vision, and prescription drug coverage. However, Medicare Advantage plans typically come with a network of doctors and hospitals, and you may need to get referrals to see specialists.

Pros

Cons

$0 or low monthly premiums

Often includes benefits like Dental/Vision and Prescriptions

$0 Preventative visits

Limited network of providers (Novant, Atrium/Wake, Duke, Cone Health)

You will pay copays for most services, and have higher annual out of pocket costs

($4,000 or higher )