Medicare Advantage and supplement plans are two important types of insurance that you may be interested in. Medicare Advantage plans are designed to cover care costs for seniors who have memory problems, dementia, or other health conditions. Medicare supplement plans are designed to provide supplemental coverage for people who do not have medical insurance. These plans can be a good choice if you have a high chance of needing medical care, but may not be able to pay the full price for hospital treatment or surgery. Here is a comparison of Medicare Advantage and supplement plans.
What Is Medicare Advantage?
Medicare Advantage Plans are often the preferred choice of seniors who want to receive the best medical care and services at a good price. The federal government created these plans to help seniors with high medical costs. The Medicare system is a national health insurance program that provides benefits to all eligible persons who meet specific income and other criteria. Premiums paid by individuals and employers fund it, and it also receives funding from the government. Medicare Advantage plans are managed by private insurance companies rather than Medicare itself.
What Is Medicare Supplement?
Supplement plans are health insurance plans that help pay for medical expenses not covered by Medicare. These plans can be a good choice if you have a high chance of needing medical care and do not want to pay full price for hospital treatment or surgery. Supplement plans will cover services not covered under your Medicare Advantage plan.
How Do Advantage And Supplement Plans Work?
Advantage Plans work like traditional Medicare. The government pays for 80% of your medical expenses, and the insurance company pays 20%. So, you pay a monthly premium that is usually less than your original Medicare cost.
Supplement plans are similar to Advantage plans but offer additional benefits such as vision and dental coverage. These plans are designed to replace the services your original Medicare does not cover. So, if you have a high deductible plan that does not cover eye care or dental work, you can purchase a supplement plan that covers those services so that you don't have to pay more out of pocket for those things.
Different Types Of Medicare Advantage Plans To Choose From
Medicare Advantage plans are made up of three different types: HMOs, PPOs, and EPOs.
● The majority of new Medicare Advantage plans are HMOs. An HMO plan is a managed care plan that requires you to go to a health maintenance organization (HMO) doctor or clinic for all your medical needs.
● PPO plans are similar to HMOs, but they allow you to get a recommendation from your primary care physician (PCP) before going to an out-of-network doctor or clinic. If the PCP recommends an out-of-network doctor or clinic, the PPO will pay a portion of the cost of that visit.
● EPO plans cover most inpatient and outpatient services as you would receive in a traditional Medicare plan. Still, they also include some additional benefits such as dental coverage and vision coverage.
Medicare Supplement Insurance (Medigap) Policies
Medicare supplement insurance is a form of supplemental coverage available if you are enrolled in Part B (Hospital Insurance) or Part C (Supplementary Medical Insurance). This is what most people think about when they hear the term "Medicare".
Medicare supplement insurance policies are similar to Medicare Advantage plans in that they cover inpatient and outpatient expenses, but they also cover prescription drugs.
Medigap is a type of supplemental coverage that is only available if you are enrolled in Part A (Hospital Insurance). Medigap covers all the same types of expenses as a Medicare policy. It also covers some additional benefits such as vision, dental, and hearing aids.
The Medigap policies are sold by private insurance companies, which have to be licensed by the state in which they do business. They are not government-run programs like Medicare.
What Are The Differences Between Medicare Supplement And Medicare Advantage Plans
Medicare Supplement plans are provided by private insurance companies, which have to be licensed by the state in which they do business. They are not government-run programs like Medicare.
Medicare Supplement plans cover all the same expenses as a Medicare policy, except prescription drug coverage.
These medicare Supplement plans also cover some additional benefits such as vision coverage, dental coverage, and hearing aids.
How Do You Enroll For Medicare Advantage Plan
Medicare Advantage plans are not available in every state. You will need to check with your state's Medicare office to determine if your state offers them.
Medicare Advantage plans are not available for everyone. If you are eligible, you can enroll in a Medicare Advantage plan.
To enroll in a Medicare Advantage plan, you will need to submit some paperwork at the time of application, including proof of age and citizenship or immigration status and Social Security number.
How Do I Enroll For Medigap Plans
Private insurance companies and state governments offer Medigap plans. Federal government agencies do not run them, and they aren't the same as Medicare Advantage plans.
To enroll in a Medigap plan, you will need to submit some paperwork at the time of application, including proof of age and citizenship or immigration status and Social Security number.
What Are The Benefits Of Medicare Advantage And Supplement Plans?
Medicare Advantage plans have some benefits that you can't find in traditional Medicare. Some of the benefits include:
● More choices of doctors and hospitals.
● Lower premiums than traditional Medicare.
● More coverage for some benefits in your plan, such as vision and dental care and prescription drug coverage.
● Premiums paid for by the federal government rather than you.
● Access to a network of health care providers who accept the plan's payment method, including health maintenance organizations (HMOs) or preferred provider organizations (PPOs).
● Choose a preferred pharmacy network if you have prescription drug coverage under the plan (some plans require you to use their pharmacy network).
● The option to enroll in a Medicare Advantage plan if you are over 65 or disabled and not eligible for full Medicare benefits yet.
Medicare Supplement Plans have some benefits that you can't find in traditional Medicare.
Some of the benefits include:
● Coverage for inpatient hospital care and medically necessary skilled nursing facility care.
● Coverage for prescription drugs not included in the Original Medicare Plan.
● Premiums that you pay instead of the federal government.
Conclusion
Medicare Supplement Plans are great options if you want to choose your doctor and have more freedom in choosing your healthcare provider. However, they do have some drawbacks. The biggest drawback is that Medicare Supplement Plans are not regulated by the federal government, which means there can be differences in quality of care between plans. Also, you cannot use Medicare Supplement plans if you are enrolled in Original Medicare or if you purchase a Medigap policy instead of Original Medicare. On the other hand, the federal government regulates Medicare Advantage plans and Medicare Prescription Drug Plans, which means there is a standard of care and quality of care that your plan must meet.
