Knowing whether a Medicare Advantage or Medicare Supplement plan is best for your health needs can be difficult. Both options are for people with Medicare, but Medigap coverage supplements original Medicare, while Medicare Advantage is a private insurance alternative to federally run Medicare. Consider the following factors as you compare benefits.
Medicare Advantage (also known as Part C) plans are provided by private insurers and essentially replace Original Medicare as your primary insurance. They cover all Medicare-covered benefits and may also provide additional benefits like some dental, hearing, vision and fitness coverage. Most of them also include Part D, which covers prescription drugs.
These plans may also come with a regional network of doctors and hospitals, meaning coverage from your plan will not travel with you. Additionally, your current doctor may not accept the plan as coverage if they are not within the plans network.
The average person on Medicare has over 30 Medicare Advantage plans to choose from—including health maintenance organizations (HMOs), preferred provider organizations (PPOs), private fee-for-service (PFFS) plans and special needs plans (SNPs). You’ll likely have a lot of choices to sort through, but not all types of plans are available in all areas.
Generally, Medicare Advantage is available for:
- Seniors age 65 or older
- Younger people with disabilities
- People with end-stage renal disease (permanent kidney failure requiring dialysis or transplant)
With Medicare Advantage plans, you must also be enrolled in Medicare Part A (hospital insurance) and Part B (Medicare insurance) and reside in the plan’s service area.
Enrollment only occurs during certain periods, but you cannot be denied coverage due to a preexisting condition.
Medicare Supplement plans (commonly known as Medigap plans) are also offered through private insurance companies. Yet, they must include the same coverage regardless of carrier.
Medicare Supplement plans help pay your share of medical costs not paid by Original Medicare, like copayments, coinsurance and deductibles. Some Medigap plans may also assist in paying for home healthcare, durable medical equipment (DME), hospital costs and lab costs.
The decision about whether to choose an Advantage or Supplement plan often comes down to whether you can afford a Medigap plan, as they can be more expensive. However, you can receive coverage from any doctor or hospital that accepts Original Medicare across all U.S. states and territories.
While Medicare Supplement plans pay secondary to Original Medicare, Medicare Advantage plans become your primary source of coverage when you enroll.
You can count on our advisors to help you understand your options. Call us toll free at (866) 235-8378 or click here to email us your name and phone number for us to call you.