You’ve just decided to buy a Medicare Advantage plan, but then someone asks you, “Have you considered getting a Medicare Supplement plan instead?” And now you’re confused. What is a Medicare Supplement plan? Isn’t it the same as Medicare Advantage?
Yes, it is confusing. But don’t worry, just read the rest of this article. We are about to explain how Medicare Supplement and Medicare Advantage policies differ.
First, Why Are These Two Types of Medicare Coverage Popular?
They are popular because they can pay certain medical expenses that are not covered by Original Medicare.
Although Original Medicare, which includes Part A and Part B, covers many health care costs, it doesn’t cover every medical expense you are likely to encounter. You could still be responsible for paying co-payments and deductibles. Also, Original Medicare doesn’t cover prescription drugs, routine vision and dental care, in-home health care assistance, and certain other costs.
To get coverage for those additional expenses, many people choose to enroll in either a Medicare Supplemental plan or a Medicare Advantage plan. You buy either of these kinds of coverage from a commercial company; you cannot buy either from Medicare itself, which as you know is administered by the U.S. Government.
Understanding the Difference Between a Medicare Advantage Plan and a Medicare Supplemental Plan
Both kinds of plans offer a way to obtain coverage for services that are not covered by Original Medicare.
But there are differences you should understand.
Medicare Advantage plans
Medicare Advantage plans act as an alternative to Original Medicare. If you enroll, you will still be in the Medicare program. However, you will receive your Medicare benefits through the Medicare Advantage plan, instead of through the federally administered program.
Though they are offered by commercial insurance companies, Medicare Advantage plans must be approved by the U.S. Government. Some plans cover additional benefits that Original Medicare doesn’t cover, such as vision or dental care, certain health wellness programs, and prescription drug coverage. In general, the more you pay for a Medicare Advantage plan, the more of these “extras” you will receive.
When you’re enrolled in a Medicare Advantage program you will need to use the network of doctors (PPO and HMO depending on your plan) for your medical care. When you visit a doctor or specialist you will pay a copay before seeing the provider.
Medicare Supplement Plans
Medicare Supplement insurance plans (sometimes called Medigap) work alongside Original Medicare, Part A and Part B, and may help pay for certain costs that Original Medicare doesn’t cover. When you buy a Medicare Supplement insurance plan, you must be separately enrolled in Original Medicare, Part A, Part B, and Part D. Medicare pays for your health care bills, while your Medigap (Supplement) plan helps defray certain expenses that Original Medicare will not cover, such as copayments or deductibles.
When you’re enrolled in a Medigap program you can see any provider who accepts Medicare and in most cases, you will have no additional out-of-pocket expenses.
Get Help in Picking the Medicare Plan that Meets Your Needs
The biggest challenge in picking the kind of policy that works best for you can be identifying your individual needs and then selecting the kind of plan – as well as the specific plan that is offered by different providers – that meets your needs, preferences, and budgets.
Don’t stress about it. CoverRight demystifies choice-making and helps you find the best Medicare coverage suited to your specific situation. Try our self-guided quiz to see for yourself….
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