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Medicare Advantage vs Medicare Supplement Insurance Plans
Medicare Advantage and Medicare Supplement Insurance Plans are both part of the health insurance program provided by the United States Government.
But what’s exactly are they? What are the bare bones basic of what you need to know about Medicare Advantage versus Medicare Supplement Insurance plans?
If you’re approaching the age of 65, you might have questions about your upcoming Medicare enrollment options.
Seniors over 65 receive automatic enrollment, but they should examine other insurance plan options. This way, seniors can be certain their needs are covered when the time comes to enroll in their benefits wellness programs.
Medicare Advantage and Medicare Supplement are additional coverage plans that accompany Original Medicare. However, there are key differences between the two. That said, it’s important to be aware of the standardized benefits that each plan does and does not cover.
Read on to find out about the two types of plans for health insurance: Medicare Advantage vs Medicare Supplement Insurance.
Medicare Advantage Plans
Medicare Advantage Plans (Part C) are not a one-size-fits-all option when it comes to additional coverage. On top of choosing this sort of plan, there are also different types within the plan to choose from. Medicare Advantage can offer complete coverage beyond Original Medicare Part A and Part B coverage. Medicare Advantage’s basic benefits include coverage for prescription drugs (Part D), vision care, dental coverage, and hearing coverage. There are also costs associated with Medicare Advantage that aren’t covered in Original Medicare premiums. Individuals must pay each premium to keep receiving the standardized coverage. However, shopping around for Medicare Advantage plan coverage is likely to benefit those seeking care plans. Comparing prices between offerings allows individuals to take advantage of significant savings when deciding.Medicare Advantage Requirements
To be eligible for Medicare Advantage plans, individuals must first be enrolled in Original Medicare (including Part A and Part B). They must reside within the service area of the plan they’re choosing as well. Individuals seeking additional benefits from this coverage must also not be at the end-stage of renal failure (unless specific conditions apply). The Medicare Advantage plan cost includes deductibles, co-pays, and coinsurance payments. These payments are different from the costs related to Original Medicare charges. If an individual has Original Medicare and Medicare Advantage, he or she may see a primary care doctor and pay towards the Original deductible. Later, the individual might visit a dentist that’s covered under Advantage and pay towards that deductible. Both payments are for separate deductibles. They do not build together toward reaching a single deductible.Types of Medicare Advantage Plans
There are several different types of Medicare Advantage plans to choose from, so it’s wise to carefully research each to make the best choice.- Preferred Provider Organizations (PPO): These plans permit individuals to see their preferred healthcare provider. This is doable so long as the doctor is in the designated plan network. Additionally, individuals don’t need written referrals to see a specialist. Also, seeing a professional chosen from the plan’s network of doctors leads to better cost coverage.
- Private-Fee-for-Service Plans (PFFS): These plans determine how much Medicare will pay a healthcare provider. From there, the plan determines how much the insured individual is responsible for covering.
- Health Maintenance Organizations (HMO): These plans require an insured individual to seek healthcare services in a designated network. To see a specialist for services, primary care doctors usually need to provide a referral.
- Special Needs Plans (SNP): This sort of plan is specifically for individuals with certain health conditions.
- Medical Savings Account Plans (MSA): This sort of plan works like a checking account, but it’s related to healthcare only. An insured individual pays for healthcare services with the account before they meet their deductibles.
Medicare Supplement
Medicare Supplement Insurance plans are also referred to as Medigap insurance or MedSup insurance. Unlike Medicare plans, Medicare Supplement is not comprehensive insurance coverage. Instead, it operates as an additional sort of medical coverage with supplemental benefits when used in conjunction with Original Medicare. One difference between Medicare Advantage and Medicare Supplement is the fact that currently, no Supplement plans cover prescription medications. Instead, Medigap insurance plans help insured individuals cover ‘out-of-pocket’ medical costs. This includes deductibles, co-pays, coinsurance, and even emergency medical care during international travel.Medicare Supplement Requirements
There is no special enrollment period when it comes to purchasing a Medicare Supplement plan. However, the best time to enroll is during the Medigap Open Enrollment period (a six-month timeline starting when an individual turns 65). By enrolling then, individuals can save money and avoid issues related to pre-existing health conditions. Enrolling during this period isn’t required. Should an individual choose to enroll at a later date, he or she should most definitely shop around to save on premium costs. Though Medigap standardizes its basic benefits, it does not standardize the cost. This means that individuals seeking coverage options need to ensure that they’re getting a decent price for their coverage.Types of Medicare Supplement Plans
Medicare Supplement coverage offers ten different plan types in 47 out of 50 states, and each plan has a letter to identify it. The plans offer the same sort of coverage, regardless of where they’re purchased when they have the same letter designation. Medigap coverage can become complicated when it comes to the out-of-pocket costs covered under each plan type. It’s a good idea to speak with a professional Medicare representative to make the most informed choice. Let’s say, for example, that an individual would like to purchase a supplemental plan. Their aim is to help cover the cost of their Original Medicare deductibles. When researching the plans offered in their state, an individual may discover that Medigap Plan C will cover the cost to some degree. However, it also may not cover the costs that Medigap Plan G covers. For this reason, it’s crucial to examine Medicare Supplement options carefully.Key Takeaways of Medigap VS Medicare Advantage
- In order to qualify for either types of coverage, an individual must enroll in Medicare Part B supplemental coverage. For Medicare Advantage, individuals must also enroll in Medicare Part A.
- Individuals cannot carry both Medigap and Medicare Advantage at the same time.
- Individuals hoping to switch from one policy type to another can do so. They should first contact Medicare to unenroll from one plan to enroll in the other.
- Medicare Advantage can cover prescription medication while Medigap cannot.
- Medigap covers out-of-pocket expenses individuals incur when they receive healthcare services. This includes co-pays, coinsurance, and deductibles.
- The best time to enroll in either plan type is during the Open Enrollment period, though it is not required when it comes to Medicare Supplement.
