Choosing the right Medicare plan can be stressful and confusing. There are so many options to choose from, and your individual health circumstances play a huge role in what plan would be best suited for you. I often hear a Medicare Advantage plan referred to as a Medicare Supplement plan and vice versa, so let’s look at some of the basic differences between these two options.
What Is a Medicare Supplement Plan?
A Medicare Supplement plan, also known as Medigap, is an insurance plan from a private insurance company that is a secondary payer to your Original Medicare. The client pays for this insurance policy monthly. The premiums vary based on your age, gender, and whether you’re a tobacco user or not. These premiums can increase each year based on these factors. The client must also pay a separate premium for a Medicare Part D prescription drug plan.
One of the attractive features of Medicare Supplment insurance is there are no networks associated with these plans. If your doctor has not opted out of Medicare, the plan pays the provider regardless of their practice or location. This applies to any Medicare doctor in any state in the US.
So for folks who are residents of one state for 6 months of the year, and may travel or have a second home for the other 6 months of the year, this may be a plan to consider. In summary, you pay for this plan every month whether you use it or not.
What Is a Medicare Advantage Plan?
Medicare Advantage plans are provided by some of the same insurance carriers that sell and service Medicare Supplement plans. However, many Medicare Advantage plans in North Carolina have a $0 premium and $0 deductible.
The interesting and sometimes confusing thing about Medicare Advantage plans is this varies by carrier, state, and county. Medicare Advantage plans are a “pay-as-you-go” plan. More literally, a “copay-as-you-go” plan.
While the premiums are $0, the client is asked to pay copays for services as they see their doctors or go to medical facilities. The client is protected by copays and a maximum annual out of pocket in each plan. These plans typically include a Part D prescription plan at no additional charge.
The other big takeaway to these plans is the competitive extra benefits offered by the carriers. So, what you hear on national commercials is true. The plans in North Carolina offer dental & vision, hearing, and over-the-counter (OTC) benefits, and sometimes transportation.
Part B Giveback is an interesting benefit, and a detailed discussion is necessary. While it is true, you may be offered less benefits in a particular area, such as dental, so it comes down to what benefits you’re looking for and what best suits you.
The Bottom Line When Comparing Medicare Advantage vs Medicare Supplement
Both plans are great insurance coverage from some of the largest and most respected insurance companies in the world. There are many other options to consider and discuss, and we would love the opportunity to assist you with a complete analysis of both Medicare Supplement and Medicare Advantage options for you.
When you begin shopping for plans, please keep Elite Senior Insurance in mind! We are independent Medicare agents and can help evaluate your plans quickly across all carriers and simplify the process for you. Contact us today online and visit our Facebook page.
