Medicare On Main — Formal Benefit Recommendation · Medicare AdvantageClick any yellow field to edit · totals update automatically · printing? turn OFF “Headers and footers”
Formal Benefit Recommendation
Medicare Advantage (Part C) pathway
Date:
Prepared for:
Your Advisor:Brian Penner
Prepared personally for you. This formal benefit recommendation maps each layer of your Medicare coverage — what Original Medicare pays, what your selected plans add, and where the remaining risks sit — so every dollar of protection is intentional.
Why This Plan Design — Where Medicare Leaves You Exposed
🏛️
Original Medicare — Parts A & B
Covers 80% of approved hospital & outpatient costs after deductibles.
Layer 1
🛡️
Medicare Advantage Plan (Part C)
Bundles hospital + medical (usually drugs too) through a plan network; copays as you go, capped by the plan's in-network max out-of-pocket — up to $9,250 (2026).
Layer 2
🎀
Cancer / Heart / Stroke Protection
Lump-sum cash at diagnosis — helps cover copays up to your MOOP, non-covered care, travel, lost income.
Formal Recommendation
🏡
Long-Term Care Planning
About 70% of people turning 65 today will need some form of long-term care — and Medicare pays $0 for custodial care, ever.
Formal Recommendation
Potential Annual Exposure Without Supplemental Coverage
Long-term care
$126,000/yr
Serious-illness yr
MOOP $9,250
Rx drugs (Part D)
$2,100/yr
Preventive care
$0 in-network
Without layers 3 & 4
$137,000+
worst-case year: LTC + plan MOOP + Rx cap
With all four layers
Protected
coverage across every major risk
7 in 10 people turning 65 today will need some type of long-term care service in their lifetime — and Medicare does not cover custodial long-term care.
U.S. Dept. of Health & Human Services (ACL), LongTermCare.gov
Core Coverage Summary
Coverage Type
Carrier / Plan
Monthly Premium
Medicare A & B *
Medicare
Medicare Advantage Plan (Part C)
Drug Coverage
Plan max out-of-pocket (in-network): · 2026 federal cap: $9,250
The 2026 brackets — what Medicare charges at each income level
Your 2024 income — single
— married filing jointly
Part B / mo
Part D / mo
$109,000 or less
$218,000 or less
standard $202.90
no surcharge
$109,001 – $137,000
$218,001 – $274,000
+ $81.20
+ $14.50
$137,001 – $171,000
$274,001 – $342,000
+ $202.90
+ $37.50
$171,001 – $205,000
$342,001 – $410,000
+ $324.60
+ $60.40
$205,001 – $500,000
$410,001 – $750,000
+ $446.30
+ $83.30
Above $500,000
Above $750,000
+ $487.00
+ $91.00
Married filing separately: $109,000 or less — no surcharge · $109,001–$391,000 — add $446.30 (Part B) and $83.30 (Part D) · above $391,000 — add $487.00 and $91.00.
2026 amounts per CMS, based on your 2024 tax return (MAGI). IRMAA applies per person and is billed by Medicare — usually deducted from Social Security — not by your insurance carrier. Amounts flow into the total above.
Your Next Steps
1Review togetherWe walk through this recommendation line by line, on your schedule — no pressure, no jargon.
2Confirm the fitWe verify your doctors, prescriptions, and carrier availability in your county before anything is final.
3We handle enrollmentPaperwork, deadlines, and carrier follow-up are handled for you, at no cost to you.
Client acknowledgment — signature & date
Advisor — signature & date
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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Medicare On Main is a licensed independent insurance agency (NPN 16493717). Not connected with or endorsed by the United States government or the federal Medicare program.
Based on 2026 Medicare rates. Figures are estimates for illustration purposes only. Individual costs vary by health status, geographic location, and plan selection. This material is educational and is not a guarantee of benefits or coverage.
