Confused about the difference between Medicare Supplements and Medicare Advantage plans? You’re not alone.
Choosing the right type of Medicare coverage for you can be tricky, but we’re here to help. In this article, I will explain the differences between Medicare Supplements vs Medicare Advantage plans and I hope it helps you decide which one is the best fit for your needs.
What are Medicare Supplements?
Medicare Supplements, also known as Medigap plans, are private health insurance plans that help cover the gaps in original Medicare coverage. Medicare supplement plans are designed to cover some of the costs not covered by Medicare Part A and Part B. This means that they provide additional coverage for medical expenses not covered by Original Medicare, such as deductibles, and copayments.
The biggest benefit of a Medicare Supplement plan is the freedom it gives you to choose any doctor or facility that accepts Medicare, without having to worry about network restrictions. In addition, many Medicare Supplement plans also provide coverage for foreign travel emergency care.
However, it is important to note that these plans do not typically cover vision, dental or prescription drugs.
Medicare Supplements are the ideal choice for individuals who are comfortable with their Medicare coverage and want the freedom of choice of doctors, as original Medicare is always the primary payer. Plus, with Medicare Supplements, clients can enjoy the fixed costs, so they know what they are paying for.
Note****When turning 65 or are new to Medicare, you will receive a one-time opportunity within the first 6 months to get a Medicare Supplement with no health questions. Foregoing this opportunity, and deciding later that you would like a Medicare Supplement, you will be required to pass an underwriting health exam. Medicare Supplement companies can deny your application.
What are Medicare Advantage Plans?
Medicare Advantage Plans, also known as Part C, are an alternative to Original Medicare. They are health plan options administered by private insurers and contracted with the government. Medicare Advantage Plans provide the same benefits as Original Medicare Parts A and B and may also offer additional coverage for things such as vision, hearing, dental, or even gym memberships.
These types of plans are typically structured as either Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs).
When you sign up for a Medicare Advantage Plan, you must choose doctors in the network who will provide you with your care. Generally, these plans offer more coverage than Original Medicare but require more restrictions on how you receive your care. It is important to read the plan details carefully before enrolling in a Medicare Advantage Plan to make sure it meets your needs.
The Pros and Cons of each type of plan
When comparing Medicare supplements versus Medicare advantage plans, it’s important to consider the pros and cons of each type of plan.
Medicare supplements, also known as Medigap plans, are standardized health insurance plans that are sold by private companies. These plans are designed to help cover some of the gaps in coverage that Original Medicare does not provide; such as copayments, coinsurance, and deductibles. Medigap plans offer more flexibility than Medicare Advantage plans and the ability to go to any doctor that accepts Medicare patients.
The downside of a Medigap plan is that it does not include coverage for prescription drugs or additional benefits such as vision and dental.
Medicare Advantage plans, on the other hand, are offered by private companies that contract with the federal government. They provide an alternative way to receive your Medicare Part A and Part B benefits through one plan and often include coverage for prescription drugs and additional benefits like vision, hearing, and dental coverage.
The downside of Medicare Advantage plans is that they usually have network restrictions. As a Medicare Advantage member, the requirement is to use the providers in the plan’s network in order to be covered or if you go out of network your out of pocket cost could be much higher. Additionally, Medicare Advantage plans can also change each year, which can mean a loss of coverage or increased out-of-pocket expenses.
When deciding between Medicare supplements versus Medicare advantage plans, it’s important to consider all the pros and cons of each option before making a decision. It’s also important to consult with a qualified independent broker to help determine which plan will best suit your needs.