Medicare Supplement and Medicare Advantage

As the annual filing period begins, it’s a good time to examine the difference between Original Medicare, Medicare Supplements, and Medicare Advantage.

Let’s start with the original Medicare. This is a plan of the Federal Government for people over 65 (you can also qualify if you are under 65, if you are disabled). A nice plan, but it does not cover everything. There are “gaps” in the plan. As for Medicare Supplements or Medigap coverage, they are the same, designed to cover the “gaps” in Medicare.  Get a quote at https://www.medisupps.com/

With Medicare supplements, they are offered by private insurance companies, but unlike individual plans for under 65, these are the same with any carrier. In other words, “Plan G” is the same with Mutual of Omaha as it is with United National Life, as it is with Blue Cross and Blue Shield. So you do not have to think well, Blue Cross is better covered or Aetna’s plan is better, they are the same.

There are several plans that provide more or less cover. For example, “Plan F” covers pretty much everything. Plan G, covers everything except for your outpatient deductible, which is $ 162. Of course, the more coverage, the more you pay in the premium.

Let’s talk about Medicare Advantage. Medicare Advantage plans are sometimes referred to as MA plans. These are also offered by private insurance companies, but they are funded by the federal government. These plans vary from one county to another in terms of supply and premium. In some counties, you can get a premium plan for $0. Some are $ 100 for the same plan. A plan could be offered in Will County, Illinois, but not in DuPage County. It can vary to that extent. Often the out of pocket maximum is significant. Some plans are $ 6,700 out of pocket, some are $ 3,000 out of pocket. That’s perhaps the biggest question I should ask, what’s my maximum for out of pocket, on this plan? Then I could afford that if something happened.

Even with Medicare Supplement, your doctors and hospitals accept the plan when they take Medicare patients. With an MA plan, depending on your plan, the doctor might treat you today and not do so tomorrow (usually with a Private Service Charge (PFFS) plan).

I would say a Medicare Supplement Plan is better coverage in every situation; however, premium sometimes can force you into a Medicare Advantage Plan. If you only have Original Medicare because you cannot afford the premium of a supplement, then the MA Plan is a great way to go. Medicare Advantage plans are often known as Medicare Part C.

Prescription plans are known as Part D. Some MA plans come with Part D, commonly known as MAPD Plan. Supplementary plans do not come with Part D and need to be added. Before you buy a Part D plan, you should ask your broker which Part D plan suits you best. Each of them is slightly different by premium or classification of the drug.