If you are deciding between enrolling in a Medicare Supplement (Medigap) plan or Medicare Advantage (Medicare Part C) plan, remember that there is no one-size-fits-all solution for everyone. While Medicare Advantage is an alternative way to receive Original Medicare benefits, Medicare Supplement plans work alongside Original Medicare to cover out-of-pocket costs.
These plans have their differences in terms of benefits, costs, and how they work. Your budget and health needs may be suitable for one plan but not another. That’s why before you decide, you need to understand the coverage associated with both plans to make an informed decision.
Medicare Advantage Plans
Medicare Advantage plans are provided through private health insurance companies approved by Medicare. They are required to provide the same benefits as Original Medicare, but they also include extra benefits. Some Medicare Advantage plans also come with a restricted network of healthcare providers, which will ultimately decrease your out-of-pocket costs when using them, compared to receiving care or treatment outside of the network.
Medicare Supplement Plans
Medicare Supplement plans are also provided through private health insurance companies but are not alternatives to Original Medicare like Medicare Advantage plans are. In practical terms, the primary objective of a Medicare Supplement plan is to pay for some out-of-pocket expenses that are not paid in full by Original Medicare. These might include coinsurance, copays, and deductibles.
Medicare Advantage vs. Supplement Plans: Major Factors to Consider
When it comes to selecting a Medicare plan, we all have different priorities. Generally, most Medicare beneficiaries look at the following factors when deciding what policy to choose:
Costs: Check the cost of the premiums, deductibles, copays, and other out-of-pocket expenses you might incur from receiving medical care or spending time in the hospital. Generally, while Medicare Supplement plans have a higher monthly premium, the plan could result in lower out-of-pocket expenses compared to certain Medicare Part C plans. Medicare Advantage plans generally cost less and might save you money, but make sure you check if it includes prescription drug benefits.
Access to Service: Medicare Supplement plans provide the most freedom of access to health providers. It allows you to receive care or treatment from any hospital or doctor that accepts Medicare. In contrast, most Medicare Advantage plans usually limit you to the healthcare providers within their network and may not provide coverage for any out-of-network care.
Location: Those who live in more than one state throughout the year may want to opt for a Medigap plan. Some Medicare Supplement plans also offer coverage for Medicare beneficiaries outside of the United States. To receive coverage from a preferred Medicare Advantage plan instead of a Medigap plan, you must live within that particular plan’s service area.
Do you still have questions about the differences between Medicare Advantage and Medicare Supplements? Or are you looking to talk through what Medicare policy might be the right option for your situation? Contact Peritia Advisors to speak with an experienced Medicare expert today!