:max_bytes(150000):strip_icc()/GettyImages-1034426836-09499c825473459ab14a03672a665de3.jpg?strip=all)
Difference Between Medicare Advantage Plan And Supplement
admin
June 23, 2024 11:07 am
.
8 min read
Difference Between Medicare Advantage Plan And Supplement – Medicare Supplement Vs Medicare Advantage, What Are the Differences? If you’re like most people who have or soon will have Medicare, you’re looking for the best way to get affordable health care without breaking the bank.
The main difference between Medicare Supplement and Medicare Advantage is that Medicare Supplement works with Original Medicare, while Medicare Advantage (Part C) replaces Original Medicare Parts and B Parts. Part D in most cases.
Difference Between Medicare Advantage Plan And Supplement
Also Read:
Understanding the Medicare Advantage gap can be frustrating, so if you’d like to chat one-on-one, give us a call at 844-528-8688 and we’ll be happy to discuss which plan is right for you.
When To Choose Medicare Advantage Over Medicare Supplement
You may have heard of Medicare Supplements (also known as Medigap) and Medicare Advantage (or Medicare Part C) plans. These are two common options for Medicare beneficiaries to maximize their benefits, but understanding them can be a real headache. And deciding which one is right for you is even more difficult.
Also Read:
So, in this guide, we will tell you about Medicare Supplement vs. Here are simple answers to the most important questions about Medicare Advantage. We’ll explain what each option is and help you choose the best option for your needs.
We’ll cover the important differences in more depth later in this guide. But to get started, the most important thing you need to understand is:
Also Read:
A Medicare Advantage plan replaces your traditional Medicare Parts A and B. This is a new insurance provided by a private company. With Medicare Supplement, on the other hand, you keep your original Medicare parts and simply add supplemental coverage.
Medicare Advantage Plans: Same Medicare, Different Options
This means you cannot get both Medicare Advantage and Medicare Supplement. So, you should choose the right option from the beginning.
Also Read:
Before we compare your two options, let’s get some complicated terms out of the way. Understanding them now will help you better understand the difference between Medigap and Medicare Advantage.
Deductible: The deductible is the amount of money you have to pay before your Medicare benefits go into effect. For example, the Medicare Part A deductible for inpatient hospital care is about $1,400. This means that if you need hospital services, you must pay the first $1,400 before Medicare starts paying anything.
Also Read:
Benefit Period: This is the period of time before your deductible resets and you have to pay it back. It can get complicated, but the simple way to understand it is that once you pay your deductible, you won’t have to pay it again for 60 days without having a single medical need.
The Pros And Cons Of Medicare Advantage Plans Vs Original Medicare
Premium: Insurance premiums are the monthly payments you have to pay to keep your coverage. For example, the standard copay for remaining in Medicare Part B is $164.90 in 2023.
Coinsurance: The percentage of medical expenses you are obligated to pay, even after you meet your deductible. For example, Medicare Part B requires a 20% coinsurance on most services. So if you needed $1,000 worth of medical care, you would pay $200.
Also Read:
Copayment: Like coinsurance, this is a fixed amount, not a percentage. With Medicare, this primarily applies to prescription drugs (covered in Part D).
As mentioned above, Medicare Supplement is also known as Medigap. And the name really describes exactly what these plans are. Basically, they fill in the “gaps” that many people find unsatisfactory in Original Medicare.
Medigap Versus Medicare Advantage Plans
For example, many Medicare beneficiaries find deductibles too high. If you are admitted to a skilled nursing facility, you will have to pay about $1,400 before your benefits start. This can be a huge financial burden for someone with a very limited income.
Many Medigap plans eliminate this deductible entirely, so you don’t have to worry about a single medical event draining your bank account or putting you in debt. Of course, Medigap plans come with co-pays. But most people feel that the peace of mind they provide is worth the extra cost.
Also Read:
When you sign up for a Medicare Supplement plan, you still get original Medicare. You are simply adding additional coverage provided by another company. After you pay part of your Medicare bill, any remaining costs you incur will be paid by your Medigap provider. Here are the most common “disadvantages” of why people turn to Medicare Supplement plans:
There is a wide range of Medicare Supplement plans that mix and match these benefits. There’s a plan for everyone and you can read our full review here. But if you’re having trouble deciding which one is right for you, don’t hesitate to contact our Medigap experts at 844-528-8688.
Medicare Part D Vs. Medicare Advantage
Unlike Medigap, when you choose a Medicare Advantage plan, you opt out of Original Medicare. Instead, you choose a third-party insurer to manage all your health care.
Also Read:
You will continue to pay the Part B premium and may also receive an additional monthly premium from the insurance company. However, all Medicare Advantage providers must offer at least the same level of coverage as Original Medicare.
A Medicare Advantage plan is similar to buying insurance before you get treatment. You can compare companies, plans, fees and costs and choose the best option for you.
In the meantime, you’ll be tied to the health care providers that are in your plan’s network, a limitation that doesn’t come with Original Medicare. However, many premium plans include prescription drug, dental, vision and hearing coverage, which makes them attractive to many.
Top 5 Medicare Supplement Plans For 2024
One of the biggest drawbacks of Medicare Advantage plans is the limitations in choosing health care providers. These plans typically have a network of doctors, hospitals, and other health care providers, and beneficiaries may have to choose a provider within the network to receive the full benefits of the plan. Out-of-network care, unless it’s an emergency, may cost more or not be covered at all.
Also Read:
Another potential disadvantage of Medicare Advantage plans is that they may require prior authorization for certain services or procedures, which can take time and delay needed medical care.
Additionally, Medicare Advantage plans may have lower out-of-pocket costs than Original Medicare, but they often have annual limits on out-of-pocket costs. This means that if a beneficiary has higher medical expenses in a year, they may pay more out of pocket with a Medicare Advantage plan than with a Medicare Supplement plan.
Also Read:
There is no single answer to the question of Medicare Advantage and Medicare
Supplement. Instead, you should consider your specific needs to find the one that works best for you.
Also Read:
Medicare Supplement Insurance Vs. Medicare Advantage Plan
Because Medigap is just a supplement to your original Medicare, your benefits apply to any doctor or hospital that accepts Medicare. This means you’ll have a wide range of providers to choose from and won’t be tied down to a specific network.
With Medicare Advantage, you are limited to hospitals and providers that are part of the insurance company’s network. So, if you want more freedom in choosing your doctors, Medigap is the better choice for you. If you are interested in a Medicare Advantage plan but want to continue seeing your current providers, make sure they are in-network before accepting the plan.
Also Read:
With Original Medicare (and therefore Medigap), you don’t need to see specialists. Many premium plans, on the other hand, require a referral from a primary care provider to see a covered specialist. If you see a specialist without this referral, you will have to pay all the costs out of your own pocket.
So if you want the freedom to choose when to see a specialist, Medigap is probably the way to go.
Also Read:
Medicare Advantage Vs Medigap Use Chart To Compare Plans
This is where the comparison gets a little tricky. Exact costs vary greatly depending on the exact coverage you choose. For Medicare Supplement and Medicare Advantage, you’ll continue to pay a monthly Part B premium, and here’s what you can expect:
Medicare Supplements do not include prescription drug coverage. If you choose Medigap, you’ll need to enroll in Medicare Part D to get prescription coverage.
Most Medicare Advantage plans include prescription drug coverage. If you’re trying to decide what’s best for you, you should compare the cost of an Advantage plan with the cost of adding Part D on top of original Medicare.
Also Read:
Medicare supplements do not include dental, hearing, or vision coverage. Many premium plans include some or all of these services. You’ll have to shop around to find a plan that covers what you need, but if you want to avoid high costs for these types of care, a Medicare Advantage plan may be best for you.
How Do Medicare Supplement Plans Work?
Medigap has relatively relaxed rules when you can
Difference between medicare supplement insurance and medicare advantage plan, difference between a medicare supplement and advantage plan, difference between medicare supplement and advantage plans, difference between medicare supplement and advantage plan, difference between medicare supplement plans, difference between medigap and medicare advantage plans, what is the difference between medicare advantage and medicare supplement, difference between medicare advantage and medicare supplement, difference between a medicare supplement and an advantage plan, difference between medicare and medicare advantage, what is difference between medicare supplement and advantage plan, difference between medicare and advantage plans
Also Read: