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MEDICARE SUPPLEMENT VS. ADVANTAGE PLANS

While Medicare Parts A (Hospital Coverage) and B (Doctor Visit Coverage) combined, cover roughly 80% of total required medical coverage - you can choose between Advantage Plans (Operate similar to a in-network HMO) or Medicare Supplement (Medigap Plans) tailored to your individual coverage needs over time. You have a myriad of options to close potential gaps in your coverage between both Advantage and Supplement Plans - Read on below to determine what's best for you. 

To help cover the gaps in what Medicare does not cover, most people look for additional private insurance options, with two primary choices: 

 

  1. Stick with Original Medicare A&B and purchase a separate Medicare Supplement Plan (also known as a Medigap plan). You will also want to purchase a Part D Prescription Drug Plan. 
     

  2. Leave Medicare and instead join a Medicare Advantage Plan (Part C) like you see advertised on TV you see advertised by some of your favorite childhood stars.  

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Before making this decision, you need to consider:
 

  1. Monthly premiums - Medicare Advantage Plans are typically zero premium, while Supplement Plans have a monthly premium.
     

  2. Out of Pocket costs - meaning the extra costs you will have to pay above your premiums - Supplement Plans have very low out of pocket costs, while Advantage Plans can have very high out of pocket costs up to $10,00 per year. 
     

  3. Whether you expect to need care from a specialized medical facility that may be outside of your network or immediate geography. Supplement plans can be used at any provider that accepts Medicare, anywhere in the U.S. while Advantage Plans typically have network and geographical limitations.
     

  4. Understand that once you choose a Medicare Advantage Plan, you may be unable to purchase a Supplement Plan in the future based on your answers to the insurer’s medical questionnaire.
     

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If you’d like help understanding your options, an agency, like Monmouth Shore Agency, can help you choose, at no cost to you. Medicare.gov provides many helpful resources, or you can call a plan directly to learn more.

 

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