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Comparative analysis of Medicare Supplement Insurance vs Medicare Advantage Insurance
You might be shocked (or even overwhelmed) by the number of options you have to think about when it comes time to investigate your Medicare options. Here is a summary of Medicare Advantage and Medicare Supplement plans along with some information to think about as you select the best Medicare plan for you.
Medical Advantage Program
Part A, Part B, and frequently Part D coverage are all included in Medicare Advantage insurance plans, also known as Medicare Part C plans. Some Medicare Advantage plans may also include extra benefits including hearing, dental, and vision coverage that are not included in Original Medicare. These Medicare plans can also have monthly premiums of nothing.
Despite being governed by the government, private insurers that sell these plans establish their own monthly premiums. Most Medicare Advantage plans also provide prescription medication coverage, but other plans may include additional benefits like vision, hearing, and dental coverage.
Similar to private health insurance plans, Medicare Advantage plans can cover a variety of out-of-pocket expenses and/or co-pays. Others will only cover doctors and facilities that are in the HMO or PPO network, while some offer HMO or PPO plan alternatives and some may pay a percentage of out-of-network treatment.
Medicare Supplement Insurance (Medigap)
Private insurance that adds to Medicare Parts A and B are Medicare Supplement insurance plans, sometimes referred to as Medigap insurance plans. These plans assist with the copayments, coinsurance, and deductibles that Parts A and B do not cover.
Medicare Supplement Program
To get a Medicare Supplement or Medigap policy, you must have both Medicare Parts A and B. Each Medigap coverage adheres to Federal and State laws to protect you, and these policies are uniform.
Plans for Medicare Supplement insurance are sold by private health insurance firms, but each standardized Medicare Supplement policy must include the same fundamental benefits regardless of the company that offers it.
What distinguishes Medicare Supplement from Medicare Advantage?
The key distinctions between Medicare Advantage and Medicare Supplement are summarized below.
| Plan Details | Medicare Advantage | Medicare Supplement |
|---|---|---|
|
Ability to make changes |
Two open enrollment periods each year |
One enrollment period per lifetime except for special circumstances |
|
Prescription Drug Coverage |
May cover |
Does not cover |
|
Routine dental, routine hearing, routine vision |
May cover |
Does not cover |
|
Coinsurance and copayments |
Usually has coinsurance and copayments |
May cover all coinsurance and copayments |
|
Restrictions on network providers |
Yes |
No |
|
Standardized benefits |
No |
Yes |
|
Monthly premium |
As low as $0 |
Usually has a monthly premium |
|
Part B deductible |
May have no deductible |
Depends on plan |
|
Part B premium |
Must pay |
Must pay |
How to Choose the Best Medicare Supplement or Medicare Advantage Plan for You Based on These Three Criteria
1. Medicare Cost Implications
For some people, price is the most crucial factor, taking into account premium prices, fees associated with potential hospital stays or medical care, such as deductibles and co-pays, etc. In comparison to some Medicare Advantage plans, Medigap coverage often has a higher monthly premium but may result in reduced out-of-pocket costs. Medicare Advantage plans can be a better choice for someone on a tight budget because they often cost less and cover more services.
2. Access to Medicaid Services
Having access to the most services (and the most freedom to choose preferred providers) is frequently first and foremost for people who have a history of needing intensive medical care or hospitalization or who anticipate needing these in the future. Medicare Advantage plans typically restrict you to using the hospitals and doctors in the HMO or PPO, and they might not pay for any care received outside of those networks. You are protected by Medigap coverage whenever you visit any hospital or medical institution that accepts Medicare.
3. Personal Preferences
Medicare Advantage programs are only available in a specific area. A Medicare Supplement insurance plan may be a better option than a Medicare Advantage plan if you frequently move between states. This may also be the case if you travel frequently, as Medicare Advantage plans typically do not offer coverage for travel outside of the US or in all 50 states, in contrast to some Medigap plans.
Are you prepared to go shopping? Let us evaluate your Medicare options.
We make it simple to find the best Medicare coverage at DreamhealthQuotes. We can quickly compare all of the Medicare plans that are available to you to help you select coverage that both meets your needs and your budget.
