It’s common to confuse Medicare Supplements with Medicare Advantage, but they’re not the same. A supplement policy can have different costs, coverage, enrollment periods, and network restrictions than a Medicare Advantage program.
Medigap Plans Add to Your Original Medicare Benefits
The main thing you need to remember is this: Medicare supplement insurance, or Medigap, is coverage that can be added to Parts A and B. Medigap plans only “supplement” your Original Medicare benefits.
Medicare Advantage Is an Alternative to Parts A and B
Medicare Advantage, or Part C, is an alternative to Original Medicare. So, you’re choosing to get your benefits from a private carrier — instead of Medicare — for the remainder of the calendar year. You can always go back to Original Medicare during an official election period.
Both Are Offered By Private Insurers
Both Medigap plans and Medicare Advantage plans are offered by private insurance carriers approved by Medicare. With either option, you keep paying a monthly Part B premium to Medicare.
- Do you want to choose your provider or are you ok with choosing a provider from within a network?
- Would you prefer to buy a separate Part D plan or receive prescription drug coverage included in one plan?
- Would you rather pay higher monthly premiums and have lower out-of-pocket costs for services you get or pay a low or $0 monthly premium and co-pays for services as used?
If you need help deciding, consult the agents at Bobby Brock Insurance.
|Medicare Supplement Plans||Medicare Advantage Plans|
|Costs||In addition to your Part B premium, you pay a monthly plan premium. You have limited out-of-pocket costs when you use services.||Typically, you pay a low or $0 monthly premium besides your Part B premium. You pay deductibles, copays, and coinsurance when you receive health care services.|
|Doctors and hospitals||You can choose your doctors and hospitals — as long as they accept Medicare patients.||You may have to use doctors and hospitals in the plan network.|
|Referrals||You can visit specialists without referrals.||You might need referrals and might be required to use network specialists.|
|Network||No network restrictions. You get nationwide coverage.||You could have network restrictions. Emergency care is covered when you travel within the U.S. and sometimes abroad.|
|Enrolling||You can apply to buy a plan any time after you turn 65 and enroll in Medicare Part B.||Typically, there are certain periods during the year when you can enroll or switch to another plan.|
|Prescription drug coverage||Not included. Consider also buying a Medicare Part D plan.||It’s included with most plans.|
Look at the Big Picture
When choosing between the two, think about the whole picture. How will you use your plan benefits? Have you considered all the expenses of Medicare?
A Medicare supplement plan helps pay some out-of-pocket expenses not paid by Original Medicare, such as deductibles, copays, and coinsurance. There’s no limit on these costs with Original Medicare, and different plans cover different services. You pay a monthly supplement plan premium, the Medicare Part B premium, and a premium for a Part D drug plan — if you would like one.
Most Medicare Advantage plans provide everything in one policy, including prescription drugs.
You pay a low or $0 premium, and deductibles, copays, and coinsurance when you use services. Each Medicare Advantage plan has an annual out-of-pocket cap. Premiums don’t count toward the maximum, so you continue to pay the Part B premium.