There are many options available to those who are eligible for Medicare. Two of the most common are Medicare Advantage and Medicare Supplemental insurance. Both have their pros and cons, which can make it difficult to decide which is best for you. In this blog post, we will compare and contrast Medicare Advantage and Medicare Supplemental insurance, so that you can make an informed decision about which plan is right for you.
Medicare Advantage Plans
Medicare Advantage plans offer additional features and benefits – beyond Medicare Parts A and B (Original Medicare). Most UnitedHealthcare Medicare Advantage plans include*:
- $0 copays on most common prescriptions**
- $0 copays for primary care visits
- Vision and dental coverage
- Fitness programs
Medicare Supplement Insurance Plans
Medicare only pays for some things. This is where Medicare Supplement plans can help cover the gaps. Also known as “Medigap,” these plans complement your existing Original Medicare coverage.
Depending on the plan you choose, you may receive coverage for many out-of-pocket expenses that Part A (hospital) and Part B (doctor) don’t cover, such as:
- Deductibles
- Coinsurance
- Copayments (copays)
Below is a Comparison:
Medicare Advantage
Doctors & Hospital -You may be required to use doctors’ and hospitals’ in-network
Referrals- You may need referrals and have to use a network Specialist, depending on the plan
Coverage When Traveling- Non-emergency care might depend on your plan’s service area. Emergency care is covered in the United States. Enrollment- Generally, there are specific times during the year when you can enroll or switch your coverage with a different medicare advantage plan
Costs-Generally you pay a low monthly premium in addition to your part B premium. When you use services you pay copays, coinsurance, and deductibles up to a set out of pocket limit
Medicare Supplement
Doctor & Hospital-you can select your doctors and hospitals that accept medicare
Referrals-You can see any specialist without a referral
Coverage When you Travel-Coverage goes with your travel across the country and depending on the coverage cover you abroad when traveling.
Enrollment-You can apply to buy a plan any time after you turn 65. However, if you apply during your Open Enrollment Period you are guaranteed coverage at the best available rate for you regardless of your health status
Costs-For Medicare-approved doctor and hospital services you will pay a monthly premium and your part b premium. When you use services, you will have low or no copays and coinsurance depending on the plan you have selected.
Prescription Drug Coverage- There is no drug coverage with these plans
What are the Different Medicare Advantage Plans
There are four types of Medicare Advantage plans: Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, and Special Needs Plans (SNPs). HMOs and PPOs are the most common.
What is a Health Maintenance Organization (HMO)?
A Health Maintenance Organization is a type of Medicare Advantage plan that requires you to use doctors and hospitals within the plan’s network, except in an emergency. You will likely need referrals to see specialists.
What is a Preferred Provider Organization (PPO)?
A Preferred Provider Organization is a type of Medicare Advantage plan that gives you the flexibility to see out-of-network doctors, but you will pay more for their services. You do not need referrals to see specialists.
What is a Private Fee-for-Service (PFFS) plan?
A Private Fee-for-Service plan is a type of Medicare Advantage plan where you can go to any doctor or hospital that accepts the plan’s terms and conditions. You do not need referrals to see specialists.
What is a Special Needs Plan (SNP)?
A Special Needs Plan is a type of Medicare Advantage plan designed specifically for people with certain chronic conditions, such as diabetes or heart failure, or people who live in nursing homes.
What are the Different Supplemental Plans?
There are ten different Medicare Supplement plans, each identified by a letter. The benefits offered by each plan are standardized by the federal government, but the premiums can vary by the insurance company. The top two plans are considered to be the G plan and the N plan.
What is the G Plan?
The G plan is the most popular Medicare Supplement plan. It covers all of the gaps in coverage left by Medicare Part A and Part B, including hospice care, coinsurance for skilled nursing facility stays, and deductibles for both Part A and Part B.
What is the N Plan?
The N plan is the second most popular Medicare Supplement plan. It covers all of the gaps in coverage left by Medicare Part A, including hospice care and coinsurance for skilled nursing facility stays. It also covers some of the gaps in coverage left by Medicare Part B, including the deductible and copays for office visits and outpatient procedures.
In closing, there are Pros and Cons to all these programs. Understanding why one of these options makes sense for you is our job. Please do not let the process overwhelm you. Give us a call and we can help make this a lot easier to break down and understand how to compare the two options.