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Coverage Proposal

Medicare Advantage (Part C) pathway
Medicare On Main
Date:
Prepared for:
Your Advisor:Brian Penner
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.
Worth Discussing
🏡
Long-Term Care Planning
The only coverage for custodial care. Medicare pays $0 for this — ever.
Worth Discussing

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
Core Coverage Summary
Coverage TypeCarrier / PlanMonthly Premium
Medicare A & B *Medicare
Medicare Advantage Plan (Part C)
Drug Coverage
Plan max out-of-pocket (in-network):    ·  2026 federal cap: $9,250
Additional Coverage
Coverage TypeCarrier / PlanMonthly Premium
Hospital Indemnity
Dental, Vision & Hearing
Cancer-Heart-Stroke Protection
Short Term Recovery Care
Long Term Care Planning
Estimated Monthly Premium Total auto-calculated $202.90
*IRMAA Calculator — Income-Based Surcharge (2026)
Enter income to estimate IRMAA
AdjustmentMonthly EstimateNotes
Part B IRMAAAdded to the $202.90 standard Part B premium
Part D IRMAAPaid to Medicare on top of your drug plan premium
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.
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