medicare advantage vs. supplement plans

Will you be turning 65 soon? Are you considering Medicare enrollment and how it can benefit you?

Selecting the right Medicare plan for you can seem like an overwhelming task at first. Beyond having your basic medical needs covered, you’ll also need to think about additional coverage. These come in the form of Medicare supplement plans or a Medicare Advantage plan. 

Yet how can you determine which option is right for you? What is offered by Medicare Advantage vs. supplement plans, and is either option worth it?

Let’s take a look at what you need to know.

What Is Medicare Advantage?

There are two basic parts of Medicare that you will sign up for when you enroll: Medicare Part A and Medicare Part B.

Medicare Part A covers things like hospital care and home health care. It’s free after age 65 as long as you get retirement benefits from Social Security, or if you’re eligible for Social Security benefits. 

Medicare Part B covers things like doctor visits and healthcare providers’ services. It may also cover things like medical equipment and preventative services.

The standard premium for Medicare Part B is $148.80 per month. However, you could pay a bit more if your income is higher. 

Medicare Advantage Plans are sometimes called “Part C.” They are offered by private companies that follow the rules set by Medicare.

If you join a Medicare Advantage Plan, you’ll get most of your Part A and Part B coverage through it. Most Advantage Plans also include prescription drug coverage, which is sometimes known as Part D. 

Advantage Plans may offer coverage for things like gym memberships, vision, or dental services. Your plan may also cover things like transportation to doctor visits.

Some Advantage plans also offer tailored benefits to those who suffer from chronic illness.

What Are Supplemental Plans?

Medicare supplemental plans are sometimes known as “Medigap” plans because they fill in the gaps left by Original Medicare. They cover almost all Part A and Part B services.

You cannot, however, sign up for both Medigap and Medicare Advantage plans. You’ll need to do your research and choose one or the other based on your unique medical needs.

Medigap plans may cover things like coinsurance or copayments. There are about 10 different Medigap plans available, and the one you choose will depend upon your anticipated medical needs.

For example, some plans may cover a stay at a skilled nursing facility or coverage while you’re traveling overseas. They may also cover deductibles and hospital costs.

You can enroll in a Medigap plan during your initial enrollment period or during open enrollment.

Medicare Advantage Vs. Supplement Plans

It’s important to note that neither Medicare Advantage nor supplemental Medigap plans are superior to the other. The right choice for you will depend upon your situation.

For example, if you prefer to have all of your coverage rolled into one plan, you might be better suited to Medicare Advantage. This may also be preferable if you take a lot of prescription drugs and know having prescription drug coverage would save you money. 

Maybe you frequently need glasses or dental work. If this is the case, Medicare Advantage can cover these services and help to keep your costs down.

If, however, you value being able to see whichever doctors you choose, you may prefer supplemental plans. This is because many Advantage plans often require that you stay in-network, although some do not. Supplemental plans can also benefit you if you anticipate having a lot of copays, deductibles, and coinsurance. 

If you anticipate a lot of international travel in your retirement years, you may want to look into a Medigap plan. This is because your medical needs will be mostly covered if you have an emergency while overseas.

It’s important to know that your Medigap plan will only supplement Original Medicare. Most of these plans won’t cover Part D prescription drug coverage. However, you can choose to purchase Part D along with your Medigap plan.

Choosing a Plan

Choosing a Medicare or Medigap plan is an important decision, and you’ll need to ask yourself some important questions first. You will obviously want to choose the plan that will provide you with the best coverage and help you save money on medical needs.

For example, are you willing to be restricted to a certain network of doctors and specialists, or do you want the freedom to see any doctor you want? How much do you typically spend on prescriptions? And how much can you afford to spend on your monthly premium?

Medicare Advantage offers some benefits you may find are worth the extra monthly costs. For example, do you anticipate needing transportation to your doctor visits in the future? Would a free gym membership help out your finances?

If you’re considering Medigap, know that you may be able to get a Medigap household discount. This can happen if both you and your spouse choose the same plan and purchase it from the same company.

Consider how often you see doctors and specialists, as well as what your monthly financial needs will realistically entail. As long as you plan and budget properly, you could choose a great plan in no time.

Moving On

There are a number of pros and cons to consider when weighing Medicare Advantage vs. supplement plans. With the right research, you could have a worry-free retirement with all of the medical care you need.

Don’t stop getting smart about your Medicare coverage now. For comprehensive options in your area, contact us today.