Medicare Supplements vs Medicare Advantage

Which option is right for you?

A lot of the people I speak to are confused about which way to go when it comes to Medicare. Do they go with traditional Medicare and get a Supplemental Plan, or do they opt to go with an Advantage Plan? I am merely giving you the facts to consider when deciding what’s going to work for you. Here are some things to consider:

Medicare Supplements, or Medigap plans, work with your Traditional Medicare. There are no networks and if your doctor accepts Medicare then they will accept your Supplemental Plan as well.

Medicare Advantage requires you to forfeit your rights to Medicare as it is a privately managed Medicare policy. You have to stay in the network or you could be responsible for more if not all of the cost, depending on which Advantage plan you decide to enroll.

Medicare Supplements premiums start of at around $80.00 per month; it varies from county to county and company to company. You will have the premium on top of the Part B monthly premium. You would also need to purchase a separate Part D Plan. Those Plans vary and it is important to pick the right plan for you. Cheaper does not always mean better. It won’t do you any good if the Part D plan you purchase does not cover all of your Medicines.

Advantage plan has a premium that ranges from $0.00-$150.00 depending on your area. This would also be on top of the Part B premium that you will be charged. Some of these plans offer prescription coverage in it as well, but remember you need to find one that will cover all of your medications. Some of these policies also offer very limited Dental, Vision, and Hearing coverage as well.

Medicare Supplements will have a very limited if not $0.00 deductible. Plan F you have no additional out of pocket charges other than your monthly premium. Plan G requires you only pay the Part B deductible of $183.00*. Plan N requires the same $183.00 deductible and then you also have to pay a $20.00 co pay for doctor visits and $50.00 copay for emergency room visits where you are not admitted into the hospital.

Medicare Advantage has a maximum out of pocket up to $6700.00 in a year. If you are admitted into the hospital, most plans require you to pay up to $300.00 per day for the first 5-7days. You will also have a copay to your doctor from $5.00-$50.00 per visit. Emergency room visits could have$75.00 copay.

Medicare Supplements allows you more freedom with regards to your Healthcare. You treatment is between you and your doctor. If a procedure is Medicare approved and it will fix what ails you then after you and your doctor discuss your options, you get the procedure done. You have no networks so you can choose the hospital that is right for you, provided they accept Medicare.

Medicare Advantage plans require you to get pre-authorization before getting a procedure. If they decide it would be best for you to get another type of procedure to fix what ails you then you have to go that route or you could be responsible for the entire cost of the procedure.

Medicare Supplements can be changed at any time. After your open or initial enrollment period you would have to answer health questions, but that is the only requirement.

Medicare Advantage generally requires you to be in the policy for the year. There are Special Enrollment Periods, but after the first year unless something drastic happens you are going to be locked into the policy for the year. You will be able to switch during the Annual Enrollment Period, Oct.15-Dec.7th.

These are just some of the things to consider when deciding which option is right for you. I strongly suggest speaking with a licensed agent to make sure you have all of the information you need to make the best decision for you. I personally know of a good guy to call, his name is Randy Lawson and he can be reached at 803-563-8534 or you can email him at thehgogroup@gmail.com. Please let me know if you have any questions.

All the Best,

Randy