Medicare Advantage plans and Medicare Supplements both provide beneficiaries with a way to minimize and control out-of-pocket health costs and maximize their benefits. Additionally, both types of senior health insurance are strictly regulated by federal and state insurance laws. However, these types of health insurance plans work very differently, and it is important to understand the difference before you decide which Medicare health insurance plan is best for you.
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Compare Medicare Advantage vs. Medicare Supplements:
- Supplements: Medicare Supplements, also known as Medigap plans, help cover some medical expenses that Medicare Part A and B do not pay for or fully pay for. These expenses might include uncovered services, deductibles and copays. When you have a Supplement, you use it with your original Medicare card and benefits. These plans come from private health insurance companies, and you do have to pay a monthly premium as you would with other types of health insurance.
- Medicare Advantage: Private insurers also market Medicare Advantage plans, and they are required to provide benefits that are equal to or better than those provided by original Medicare. However, you only use your Medicare Advantage plan card when you access services as an enrolled member. You are still a Medicare beneficiary, but you only access health services through your plan.
Advantages of Medicare Advantage Plans
Medicare Advantage, or MA, plans might also require an additional premium besides the Part B premium that may get withdrawn from your Social Security payments. However, this premium is usually very modest. Some plans do not require an additional premium and some even rebate part of the Part B premium.
Probably the biggest advantage of an MA plan, compared to traditional Medicare, is that they include a maximum yearly out-of-pocket limit. Even though MA plans may also require members to pay copays and deductibles, after this limit has been reached, all covered services are picked up by the insurer.
What about prescriptions? Some MA plans also come with Part D prescription drug coverage. It might be simpler to manage your health and prescription medication insurance with one policy. However, some plans do not come with prescription coverage, and you still need to enroll in a separate Part D plan.
Advantages of Medicare Supplements
Remember that these policies are not just “as good or better” than original Medicare. You already have original Medicare, and a Supplement adds to that coverage. That is why they are called supplements. So it is likely that most Supplements will reduce or eliminate many out-of-pocket costs. Premiums are likely to be higher than they are for MA plans, but they should provide more coverage.
Which Medicare health insurance is best?
The right answer really depends upon your health care needs, where you live and your budget. It might even depend upon the products that insurers happen to market in your city or town.
For example, you might live in an area with a very good MA HMO that includes your favorite doctors and other medical providers. Additionally, the chance to get $0 additional premium MA plans might be very attractive for people with limited budgets and fixed incomes. Also remember that not all MA plans are HMOs, and you can also find PPOs and other types of health insurance plans that allow you to access more covered services outside of a network of medical providers.
Additionally, some MA plans address the needs of people with specific chronic health conditions. These specialized plans could provide good solutions for people with specific illnesses and situations.
However, those who would rather pay their premiums and know that many expensive services will get fully covered might be happier with a Medicare Supplement. Again, the monthly premium might be higher, but a Supplement may reduce out-of-pocket costs a lot more.
Let us help you compare Supplements and Medicare Advantage Plans
Your own choice may depend upon prices and available plans in your local area. You can start comparing Medicare Advantage plans vs Medicare Supplements.
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At Trusted Senior Specialists, we hope to help every Medicare recipient find the senior health insurance that best fits their unique health needs and budget.