Medicare Advantage vs. Supplement Plans

There are a variety of different ways to obtain and customize your Medicare coverage. It is crucial for you to understand the difference between Medicare Advantage and Medicare Supplement plans when purchasing your insurance. The only thing these two plans have in common is that are offered by private insurance companies!

The type of plan you choose will influence your costs, benefits, and vary in how they work. Both Medicare Advantage and Medicare Supplement (also referred to as Medigap) plans are ways to replace or work alongside your Original Medicare.

Original Medicare is your Part A and Part B plans. These parts are your hospital and medical insurance. They will cover any inpatient and outpatient care, including lab tests, surgery, home health care, and services from your doctor or other health care providers (to name a few). You must meet specific age or disability requirements to qualify for Original Medicare.

You are still responsible for some out-of-pocket costs such as copayments, coinsurance, and deductibles with Original Medicare. This is where a Medigap plan comes in. There are ten standardized plans that each pertain to individual out-of-pocket costs (to some degree). Meaning, all Medigap plans will cover your Original Medicare (Part A & Part B) deductibles. Each Medigap plan is given a letter designation and should offer the same benefits regardless of which private insurance company you purchase your policy. However, costs can fluctuate as are the plans offered depending on which state you live.

If you would like to enroll in a Medicare Supplement plan, make sure you read each policy carefully. Also, the best time to sign up is during the six month Medigap Open Enrollment Period which starts the month you turn 65 and have Medicare Part B. This is the best time because you are guaranteed a plan and can’t get charged extra for any health conditions you may have.

A Medicare Advantage Plan administers your Original Medicare benefits (both Part A and  Part B are required to have) but can also provide you additional benefits including prescription drug coverage and routine appointments such as dental, vision, and hearing. There are a variety of options for a Medicare Advantage plan: Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service, Medical Savings Account, and Special Needs plans. These plans involve receiving care from providers within a recommended or required network and differ how the amount paid is determined. These plans are not standardized, so the coverage and costs will vary. You can enroll in these services at any time. The only requirements are that you are enrolled in Original Medicare, resident in the plan’s service area, and do not have end-stage renal disease (ESRD).

Regardless of which plan you choose, it is vital that you shop around carefully and note the costs and coverage of each. We understand it can be a confusing and overwhelming process, so let us help!

Call your local Avery Hall Insurance Group, today! Any of our experts would love to assist you in learning more and enrolling in Medicare.

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