Updated: Jan 28
Which path you take will determine how you get, your medical care, and how much it costs.
During the Annual Enrollment Period, as well as for those of you who are 64 and approaching Medicare age, you may be thinking about how Medicare will cover your health care costs. Well a comparison of Medicare Advantage versus Medicare Supplement Plans may be in order.
What’s the Difference Between Medicare Advantage and Medicare Supplement Insurance Plans?
There are different ways that you can receive your Medicare coverage. Medicare Advantage and Medicare Supplement plans are options that may sound similar, but they’re quite different. They do have one main thing in common: they’re both offered by private insurance companies.
There are two options commonly used to replace or supplement Original Medicare.
One option, called Medicare Advantage plans, are an alternative way to get Original Medicare.
The other option, Medicare Supplement (or Medigap) insurance plans work alongside your Original Medicare coverage.
These plans have significant differences when it comes to costs, benefits, and how they work. It’s important to understand these differences as you review your Medicare coverage options.
Medicare Advantage plans offer an alternative way to receive your Medicare benefits through a private, Medicare-approved insurance company. They must include all your Medicare Part A and Part B coverage, and they may offer additional benefits not included in Original Medicare.
You generally cannot enroll, in both a Medicare Advantage plan, and a Medigap plan, at the same time.
Medicare Advantage plans
If you have a Medicare Advantage plan, you’re still enrolled in the Medicare program; in fact, you must sign up for Medicare Part A and Part B to be eligible for a Medicare Advantage plan. The Medicare Advantage plan administers your benefits to you. Depending on the plan, Medicare Advantage can offer additional benefits beyond your Part A and Part B benefits, such as dental, vision, and hearing coverage, prescription drug coverage, wellness plans, transportation benefits, as well as well as an allowance for purchasing over-the-counter items.
Every major insurance company, including Aetna, Cigna, Humana, United Health, just to name a few, offer Medicare Advantage plans. Once you enroll in a Medicare Advantage plan, you are committed to that plan until the next annual enrollment period, which goes from October 15 to December 7th each year, unless you qualify for a special enrollment period.
If you decide to sign up for a Medicare Advantage plan, you may want to shop around, because benefits, costs and coverage details are likely to vary.
Medicare Supplement plans
Medicare Supplement insurance, also known as Medigap or MedSupp, is also sold through private insurance companies, but it is not comprehensive medical coverage.
Let me repeat that important point: Whereas Medicare Advantage plans provide comprehensive medical coverage, Medicare Supplement plans do not.
Instead, Medigap functions as supplemental coverage, to Original Medicare.
Current Medigap plans don’t include prescription drug coverage.
Medigap plans may cover costs which include Medicare coinsurance and copayments, deductibles, and emergency medical care, while traveling outside of the United States. There are 10 standardized plan types, each given a lettered designation (Plan A, G, N, for example). Plans of the same letter, offer the same benefits, regardless of where you purchase your plan. Again, plans of the same letter, Plan A for example, offer the same benefit, no matter which insurance company, you purchase the plan from.
So, if you’d like to enroll in a Medicare Supplement insurance plan, you might want to compare the Medigap policies carefully.
While benefits are standardized, the costs are not, meaning they could fluctuate depending on the insurance company offering the plan.
That is, while Medigap Plan G includes the same coverage no matter where you buy it, the premium for this plan can and will vary. Also, premiums typically increase for Medigap plans each year.
If you decide to sign up for a Medigap policy, a good time to do so is during the Medigap Open Enrollment Period, which is a 6-month period that typically starts the month you turn 65 and have Medicare Part B. If you enroll in a Medigap plan during this period, you can’t be turned down or charged more because of any health conditions.
But if you apply for a Medigap plan later, you may be subject to medical underwriting and your acceptance into a plan isn’t guaranteed.
No matter whether you enroll in a Medigap policy or a Medicare Advantage plan, you must continue paying your Part B premium.
In summary, As a current or future Medicare beneficiary, you want to make certain you are informed about your choices. The plan you choose will have a direct impact on your overall healthcare costs throughout your retirement.
If you have questions, please feel free to contact me at 404-335-8798 or email me at EJadviser@SiSHealth4Life.com.