Sunday, March 25, 2012

Medicare Advantage vs Medicare Supplement

Two main
options exist when it comes to covering expenses not taken care of by straight
Medicare. Medicare advantage plans and medicare medigap plans. Because there is
a lot of confusion between the two I would like to address the main
differences. Typically there are always exceptions to any rule so please check
with your qualified representative to insure your best option.
advantage plans usually have premiums that are lower that medicare supplement
plans. Additionally, prescription drug coverage is usually included in the
plan. A medicare advantage plan is typically set up as an HMO which means you
have to choose your primary care physician. If you need to go to a specialist a
referral would be required. When care is provided on this type of plan there is
usually a copay that needs to accompany the visit. Plans changes can only be
done on these plans during open enrollment periods.
There are some
medicare advantage plans that do provide a greater degree of flexibility in
choosing doctors. Those types of plans would be considered PFFS or PPO plans.
Both of these plans usually require a monthly premium.
supplement options work differently than medicare advantage plans. On a
medicare supplement plan Medicare is your primary insurer and the medigap plan
is what is called your secondary insurance. There are several types of medicare
supplement plans. For explanation purposes I will concentrate on plan F.
On a medicare
supplement plan you are not limited to having to have a primary care physician.
You can go to any doctor (primary or specialist) that accepts medicare. This
includes out of state coverage.
If medicare is
your primary insurance you will need a part D (prescription drug plan) that
will have to be purchased separately. The average cost of a plan D is $30.00
per month.
Changes on a
medicare supplement plan may be made at anytime. However the company that you
are switching to may require underwriting.
A medicare
supplement plan F would take care of doctors office visits so no copay would be
necessary. Additionally, there would be no hospital copay or deductible.
Because of the
enhanced benefits there is a monthly premium required for medigap plans.
By providing
details on the different available options my hope is that you can make an
informed decision.
For follow up
questions please come to our web site at: and compare
all of your options.