About Medicare Advantage Plans.
Medicare Advantage Plans, also referred as Medicare Complete Plans, are considered to be Original Medicare Part C.
Enrolling in a Medicare Advantage Plan is an alternative way to receive Medicare benefits through private insurance companies. Some of the most popular Medicare Advantage plans individuals are familiar with are: PPO, HMO and PPFS benefit plans.
With Medicare Advantage, you still get the benefits required by Medicare Part A and Part B. However, you receive these benefits through the Medicare Advantage plan you applied; not Original Medicare. Advantage plans can vary in coverage availability, specific to the county you reside.
Medicare Advantage vs. Medigap (Medicare Supplement)
Medicare Advantage Plans are offered through private insurance companies as an alternative way to retain insurance. Although these plans have low premiums and can sometimes cover benefits not traditionally covered by Medicare, there are limitations to physicians and out-of-pocket expenses can sometime be high..
Medicare Supplement Plans are also offered through private insurance companies, but they are designed to coordinate benefits direct with Medicare and the provider. This means that plans must be standardized and you can see any provider nationwide that participates with Original Medicare.
Below is a chart of the key differences between a Medicare Advantage and Medicare Supplement (Medigap) Plan.
|Benefit||Medicare Supplement (Medigap)||Medicare Advantage|
|Lowers costs for services?||Yes. Pays part or all of your costs when you go to the doctor or hospital.||Depends. Your costs for health care (copay or coinsurance) may be more or less then what you pay in Original Medicare. You may pay full cost if you don’t follow your Medicare Advantage plan's rules.|
|Protects you from unexpected costs?||Yes. Pays your full hospital coinsurance and pays for 365 extra days in the hospital beyond what Original Medicare covers.||No. Some types of care can be more expensive than under Original Medicare. You can’t buy supplemental insurance to pay your out-ofpocket costs. Medicare Advantage plans must have an annual out-of-pocket limit. These limits can be high but will protect you if you need expensive health care.|
|Covers extra services?||Very little. Medigap plans usually don’t cover anything that Original Medicare doesn’t cover. However, some do extend coverage outside of the United States.||Maybe. Depending on the Medicare Advantage plan, you may be covered for additional services such as; routine eye and hearing exams, dental coverage, etc. Those benefits are limited, so check carefully.|
|Lets you got to doctors and hospitals of your choice?||Yes. You can choose any doctor or hospital in the U.S. that accepts Medicare (unless you have a SELECT plan). Medigap SELECT plans only pay for care inside the network.||No. Most have a network of doctors, hospitals, etc. that you must use in order for the plan to cover your care. You may pay much for more for seeing care outside of the plans network.|
|Requires referral to see specialists?||No. You don’t need a referral.||Maybe. You often need to get a referral from your primary care physician if you want to see a specialist.|
|Has high monthly fees?||Maybe. The premium, which is the monthly fee to be enrolled in the plan, varies on the coverage you choose. You may also pay the Medicare premium each month in addition to your Medigap premium.||Generally, no. Many plans don’t charge more than what you pay Original Medicare, but some plans may. Plans that include drug coverage often cost more.|
|Limits when you can enroll?||Depends. In many states, you can enroll in a Medigap plan year-round. However, this can vary depending on your current coverage type.||Yes. You can usually only enroll or switch a Medicare Advantage plan during the Annual Enrollment Period (October 15th-December 7th). If you're new to Medicare, you must enroll during your Initial Election Period.|
Ready to Talk to an Advisor?
At Senior HealthCare Solutions, we take the time to assess your situation and review all plans to see which will be the best fit for you. To compare compare Medicare Advantage Plans and find the best Medicare Advantage Plans in your area, call us today by dialing 1-866-MEDIGAP (633-4427) or complete our Contact Form and one of our licensed advisers will be in touch.