How to Choose Between Medicare Advantage vs. Supplement Plans

in Health & Well-being

Choosing the ideal health insurance plan’s a top priority for most Americans. After all, a hospital stay can set you back almost $4,000 per day.

Fortunately, the federally-run Medicare program strives to offer everyone over a certain age affordable health care to cover all their basic needs.

However, original Medicare comes with a range of co-payments and deductibles that many people can’t afford to pay in one go.

There is a way around this though. You can buy a Medicare supplement policy or a Medicare Advantage plan that takes care of these extra costs.

So, if you’re helping your parents out with their health insurance later in life or rapidly approaching the time when you qualify for Medicare, keep reading.

Here’s how to compare Medicare Advantage vs supplement plans and get the coverage you need.

Medicare Supplement Plans vs Advantage Plans – The Basics

First, let’s take a look at how Medicare works.

Every US citizen over the age of 65 is eligible for this health insurance policy with no questions asked. You can find more information on how to sign up for Medicare here.

St George Medicare has four main parts, namely:

  • Part A coverage for nursing facility care, limited home health care, and in-hospital care
  • Part B that covers some doctor’s services, medical supplies, preventive care, and outpatient care
  • Part C which is another name for Medicare Advantage
  • Part D is optional coverage for prescription drugs and vaccines

You can also opt for one of the Medicare Medigap plans which pay for your costs related to copayments and deductibles. You pay a separate fee in addition to your Part A and Part B premiums for these plans.

Medicare Advantage plans must offer all the same benefits as Original Medicare (Part A and B). Many of them also offer the same benefits as Medigap and Medicare Part D. The difference is that you pay only one premium for these health insurance policies.

You buy both these types of plans from private insurers. In some instances, Medicare coverage is free, although most people pay monthly premiums.

Choosing Between Medicare Advantage vs Supplement Plans

There’s an overwhelming amount of Medigap and Medicare Advantage plans available.

So, don’t sign up for the first one you come across. Keep searching until you find the ideal combination for your needs.

Here’s a quick comparison of the major benefits to assist you when comparing Medicare Advantage plans vs supplement plans.

Time Frames for Enrolment

There are two open-enrolment periods for Medicare Advantage plans each year. These are from 1 January 1 to 31 March, and from 15 October to 7 December.

If you want to join a Medigap plan, you’ll need to sign up within six months of your 65th birthday, except in special circumstances.

Cost of Monthly Premiums

Premiums for Medicare Advantage plans vary widely according to the benefits offered by each plan. Some of these plans even offer a limited amount of coverage with no monthly premium.

Medigap policy premiums depend on your age, and there aren’t any free options available.

Extra Costs

No matter which of these types of insurance you choose, you’ll still have to pay your monthly Medicare Part B premium.

Some Medicare Advantage plans cover the costs of part B deductibles only, while Medicare Medigap policies pay all co-payments for Medicare Part A.

Some Advantage plans offer additional savings on things like vision and dental care as well as prescription drugs. Many of them pay for emergency medical treatment while you’re traveling too.

Medigap Plans C, D, F, G, M, and N also offer coverage for travel although plans C and F aren’t available for new Medicare members anymore.

If you were eligible for Medicare before 2020, you can still sign up for Medigap Plan F and C.

Network Restrictions

Most healthcare providers throughout the USA accept Medigap Insurance, while some Medicare plans restrict your choices regarding hospitals and medical professionals.

If you want to receive medical care from an out-of-network provider, you’ll need to pay more for your premium with most Medicare Advantage plans.

Extra Benefits Offered by Medicare Advantage Plans

Medigap supplemental insurance plans offer standardized benefits across the country. For instance, you’ll receive the same benefits with Plan N regardless of which insurer you buy your Medigap plan from.

Each state makes its own rules concerning the minimum requirements for Medigap Plans offered within its borders.

On the other hand, insurers have carte blanche when it comes to the Medicare Advantage plans they offer. Apart from a few basic benefits required by law, they can offer a host of value-added extras with their policies.

These include:

  • Assistance with structural changes for wheelchair access at home
  • Help with transport to medical appointments
  • Advice on diet and nutrition
  • Discounted gym memberships
  • Routine vision, dental, and hearing care
  • Allowances for some over-the-counter medications

If you’re still confused by all this, consider making an appointment with an insurer who offers both types of insurance. They’ll assist you in finding the perfect combination for your needs.

Get Clarity on Your Health and Wellness Questions

The realm of health insurance can be an overwhelming territory for everyone, and it’s tempting to put these decisions on hold due to indecision.

Hopefully, we’ve shed some light on any questions you had regarding Medicare Advantage vs supplement plans. Don’t wait until it’s too late. There’s a limited window of opportunity for signing up with insurance providers every year.

Would you like clarity on some more pressing issues relating to health? We’ve got you covered with a wide range of articles on health and wellness. Keep browsing our website for more.

Image Credits: Hush Naidoo

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