If you are enrolling in Medicare or are looking to change plans, you may wonder which plan is best for you. When deciding which plan to enroll in, you must first choose between a Medicare Advantage plan and a Medicare Supplement plan.
There are many differences between Medicare Advantage vs. Medicare Supplement plans. So, it is crucial to do your research and thoroughly understand how each plan type works before deciding. You are not alone in your research, and we are here to help.
What is the Difference Between Medicare Advantage and Medicare Supplements?
While Medicare Supplement plans pay secondary to Original Medicare, Medicare Advantage plans become your primary source of coverage when you enroll. Medicare pays a set amount to the carrier for the Medicare Advantage plan in which you enroll to take on your coverage needs for the calendar year.
Those new to Medicare may notice a considerable amount of Medicare Advantage plan promotion through advertisements and little to no promotion of Medicare Supplement plans. This is due to the difference in profit margins for carriers between Medicare Advantage and Medicare Supplement plans.
Depending on your lifestyle, budget, and medical coverage needs, one plan type will be more suitable for your needs than the other.
What is a Medicare Advantage Plan?
Private insurance companies offer and administer Medicare Advantage plans. These plans take on the role of primary coverage for Medicare beneficiaries. Medicare pays these private insurance companies to take on your risk.
These plans can also come with a regional network of doctors and hospitals, meaning coverage from the plan will not travel with you. Additionally, your current doctor may not accept the plan as coverage.
Medicare Advantage plans must offer the same benefits you get from Original Medicare and can also include additional benefits. However, these additional benefits vary from plan to plan. When you enroll in a Medicare Advantage plan, you agree to pay higher out-of-pocket costs in the form of cost-sharing in exchange for a lower monthly premium.
Often, Medicare Advantage plans include prescription drug coverage. While not all plans offer drug coverage, the majority of Medicare Advantage HMO and PPO plans include this additional benefit.
How Are Medicare Supplement Plans Different?
Medicare Supplement (Medigap) plans are also offered through private insurance companies. Yet, they must include the same coverage regardless of carrier. Medicare Supplement plans pick up the remaining cost-sharing for which you would normally be responsible with only Original Medicare.
Medicare Supplement plans give you the ability to predict your costs. Because all plans have the same benefits, you will always know your out-of-pocket limits. When enrolled in a Medicare Supplement plan, there is no network of doctors to which you must adhere. You can receive coverage from any doctor or hospital that accepts Original Medicare across all U.S. states and territories.
Additionally, some Medigap plans – such as Medicare Supplement Plan G – cover excess charges in states that allow them. Meaning if the doctor does not accept Medicare assignment, you will not need to pay extra because your Medigap plan protects you.
Pros and Cons of Medicare Advantage vs. Medicare Supplement Plans
There are several differences between Medicare Advantage vs. Medicare Supplement plans. A Medicare Advantage plan (Medicare Part C) is structured to be an all-in-one option with low monthly premiums. Medicare Supplement plans offer additional coverage to Original Medicare with low to no out-of-pocket costs. The chart below reviews the pros and cons of Medicare Advantage and Medicare Supplement plans.
|Medicare Advantage Plans||Medicare Supplement Plans|
|The plans are ideal for those who want a low monthly premium and do not mind paying more out-of-pocket when they visit doctors and hospitals.||These plans are ideal for those who want low out-of-pocket costs, coverage to travel with them, predictable costs, and the freedom to choose their own doctors.|
When it comes to Medicare Advantage vs. Medicare Supplements, the biggest complaint we hear from our clients is that they are unable to accurately predict their out-of-pocket costs when enrolled in a Medicare Advantage plan.
On the other hand, the biggest compliment we hear from clients is in regard to Medicare Supplement plans. Most beneficiaries stick with Medicare Supplement plans because of their ease and reliability. The option to go to any doctor that accepts Original Medicare is the cherry on top of Medicare Supplement plans.
Which is Better: Medicare Advantage vs. Medicare Supplement?
Medicare does not offer a one-size-fits-all plan. So, the best policy for you is the policy that best meets your healthcare needs.
Medicare Supplement plans are the best option if you want complete reassurance and predictability with your healthcare but are comfortable paying higher premiums in exchange for lower out-of-pocket costs. Whereas Medicare Advantage plans are the best option if you are hoping to save on monthly premiums and receive additional benefits while accepting responsibility for additional out-of-pocket costs at the doctor’s office.
For overall ease and reliability, our recommendation is always Medicare Supplement plans. However, we know that may not work for everyone. Our goal is to provide you with your best options regardless of plan type.
How Do I Choose Between Medicare Advantage and Medicare Supplement Plans?
Are you comfortable with unpredictable copayments, strict doctor networks, and referrals in exchange for a lower monthly premium and additional benefits? If your answer is yes, Medicare Advantage could work for you.
The best part about working with agents is that no matter which option you choose, we make sure it is the best for you.
Give us a call at the number above to learn about your best plan options today! Or, fill out an online rate form to connect with an agent today!