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Medicare Advantage Vs Medicare Supplement Plans

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Medicare Advantage Vs Medicare Supplement Plans: Essentials You Need to Know

If you’re a senior aged 65 and above, an Original Medicare Plan (Parts A and B) can cater for several of your healthcare costs. But it won’t cover everything. That’s where medicare supplement and medicare advantage plans come in. medicare supplement and medicare advantage plans cater for many costs not covered by Original Medicare. But what’s the difference between the two plans? Here are the essentials you need to know about medicare advantage vs medicare supplement.

What Is Medicare Advantage?

Medicare Advantage plans serve as a substitute for traditional Medicare coverage. They’re offered by private health insurance companies and basically act as your primary insurance coverage instead of Original Medicare.

In addition to providing the benefits offered by Original Medicare, some Medicare Advantage plans offer other perks like routine fitness, dental, hearing, and vision services. Most plans also include Part D, which covers prescription medicine.

However, a Medicare Advantage Plan restricts you to doctors and other healthcare professionals within the plan’s network and service area. You may also need referrals to see specialists within your network.

With Original Medicare, you won’t encounter these issues. You can visit any physician or healthcare professional who accepts Original Medicare and won’t require a referral to visit a specialist.

Who Can Enroll in Medicare Advantage Plans?

You’re eligible for a Medicare Advantage plan if you’re:

  • 65 years or older
  • Currently enrolled in both Medicare Parts A and B.
  • A U.S. citizen or legally authorized to reside in the United States.
  • A resident within the plan’s service area

You may also qualify for a Medicare Advantage plan if you’re below 65 and have Medicare due to disability.

Benefits of Medicare Advantage

Medicare Advantage plans offer all the perks of Original Medicare, including:

  • All-in-one coverage
  • Extra perks like routine dental, hearing, vision, and fitness programs
  • Prescription medicine coverage

What Is Medicare Supplement?

Medicare Supplement or Medigap plans serve as an add-on to Original Medicare, providing extra coverage. They don’t replace Original Medicare coverage. Instead, they cater for medical expenses not covered by Original Medicare, like coinsurance, copayments, and deductibles.

However, Medicare Supplement plans don’t cover prescription medicine. You must buy a separate Medicare Part D plan to cover prescription drug costs.

  • Who Can Enroll In Medicare Supplement?

    You can qualify for a Medicare Supplement plan if you’re:
    65 years and above
    Enrolled in Medicare Parts A and B
    Residing in the state where the policy you want is offered
    You may also qualify for Medigap coverage in some states if you’re under 65 but have an end-stage renal disease (ESRD) or disability.
    Benefits of Medicare Supplement
    Medicare Supplement plans offer the following benefits:
    Coverage for out-of-pocket costs not covered by Original Medicare, like coinsurance, copayments, and deductibles.
    Access to numerous healthcare facilities since you can visit any healthcare provider nationwide that accepts Medicare patients.
    Continuous coverage since your policy can’t be terminated as long as you pay your premiums when due.

  • Medicare Advantage vs Supplement: Key Differences

    Here are the primary differences between medicare advantage vs supplement plans:
    Coverage
    Medicare Advantage plans provide the same coverage as Original Medicare (Parts A and B), including other perks like routine dental, hearing, vision, and fitness services and prescription medication (Part D).
    Conversely, Medicare Supplement plans work with Original Medicare to cater for costs not covered by Parts A and B, like copayments and deductibles.
    Enrollment
    You can enroll in a Medicare Advantage plan during particular enrollment periods. On the other hand, you can enroll in a Medicare Supplement plan any time after you turn 65.
    Doctors and Hospitals
    Medicare Advantage plans may restrict you to in-network doctors and hospitals. Conversely, Medical Supplement plans don’t have network restrictions. You can visit doctors and hospitals nationwide that accept Medicare.
    Referrals
    Many Medicare Advantage plans require referrals from physicians to visit specialists. Conversely, Medicare Supplement plans don’t require referrals to visit specialists.
    Costs
    Medical Advantage plans typically have copays, coinsurance, and deductibles. Costs may vary from one plan to another, but premiums are relatively lower compared to Medigap plans. Conversely, while Medigap plans generally have higher premiums, there are minimal out-of-pocket costs.

  • Medicare Supplement or Advantage Which is Better?

    There is no right or wrong option between medicare supplement or advantage which is better. Each option has its unique pros and cons and the right option for you will depend on coverage, costs, provider network, and personal preferences.
    So, consider your circumstances before asking medicare supplement or advantage which is better, or contact us today, and we’ll help you choose a suitable plan based on your needs.