Comparing Medicare Supplement (Medigap) and Medicare Advantage
Medicare Supplement and Medicare Advantage
Choosing health insurance is a crucial decision that must be made as far as your health and future is concerned. Fortunately, when it comes to choosing Medicare, you have a lot of options to choose from. However, just like other massive insurance enterprises, Medicare can be quite confusing too, but it’s not difficult to grasp the basics either.
Medicare supplement (Medigap) and Medicare Advantage (Part C) are both additional plans that you can pair with your original Medicare (Part A and B). Both plans are designed to give you the insurance coverage that other parts of your Medicare can not provide, and may offer you all you need to achieve your individual health needs. However, you don’t have to purchase both Medicare supplement and Medicare advantage at a go; you can choose just one out of the two if you want additional Medicare coverage.
Medicare Supplement VS Medicare Advantage: What’s the Difference?
Medicare Supplement (Medigap) Medicare supplement (Medigap) is a type of private health insurance plan that offers additional coverage for original Medicare plans.
Just like its name, it helps fill in the “gaps” by helping you pay for out of pocket costs that your original Medicare plan won’t cover.
Some of these include;
- International healthcare costs
Medigap plans are provided by private insurance companies that are fully licensed to provide the plan. There are different types of Medigap plans, and they are classified as Plan A, B, C, D, F, G, K, L, M, and N. Each plan has a different coverage level. However, many people usually go for Medigap Plan F, because it has the most comprehensive coverage out of all the Medigap plans.
Medicare Advantage Often referred to as Plan C, Medicare Advantage serves as an alternative to the original Medicare plans. This plan is combined with the typical Medicare Plan A and B plans, ensuring a complete package for the insured person.
So, if you decide to go for Medicare advantage, you’ll still be regarded as a Medicare patient, because licensed private firms typically provide Medicare advantage plans, but the government funds them.
In addition to the standard Medicare coverage, Medicare advantage also covers expenses for;
- Wellness programs
Although the details vary depending on the exact plan, Medicare advantage plans can be customized to cover healthcare costs for chronic illnesses and some other conditions.
The Medicare advantage may also comprise additional expenses like;
- Daycare services for adults
- Transportation to doctor’s appointment
- Over the counter medications
Also, most Medicare Advantage plans usually include Medicare Part D Plan, otherwise known as prescription drug coverage. However, if yours doesn’t include this, you can always add a Medicare prescription drug plan.
Medicare Supplement vs Medicare Advantage: The Key Differences Although the Medicare supplement plan and the Medicare advantage plan are both beneficial, there are some significant differences between the two. Being knowledgeable about these differences can help you choose the type of plan that will work best for you.
Price Price/cost is the primary difference between a Medicare supplement plan and a Medicare advantage plan. Medigap plans generally have higher premiums than the Medicare advantage plan, and they also cover more expenses than Medicare advantage plans. This results in more out of pocket costs for Medicare advantage plan. So, you can save money by choosing the plan that best suits your condition.
Choice of Doctors Another key difference you’ll need to consider when faced with the option to choose between Medicare Advantage and Medigap plan is the choice of doctors.
Medicare Advantage plans offer a limited collection of doctors and cannot cover out-of-network doctors, while Medigap plans provide more flexibility when it comes to choosing a doctor. So, be well acquainted with the limitations the two plans have if you have a health condition that requires you to see a specific doctor.
Location Another major determinant when choosing your plan is where you are located and your lifestyle. If you live in one state and rarely travel, then Medicare advantage might be right for you. However, if you travel a lot or you live in more than one state, then Medigap plans may be a better option for you.
This is because Medicare Advantage plans offer coverage exclusively in one region only, while Medigap plans provide coverage in all 50 states in the US and when you are outside the US.
Benefits of Medicare Supplement Plans (Medigap)
Medigap plans boost Medicare Plans A and B and provide a more extensive option for the insured person by covering almost all the out of pockets costs in the Original Medicare plan.
Another benefit is the higher premium packages that Medigap has to offer. Although this attracts more costs, it however, results in little to no out of pockets costs.
Also, the older you are when you enroll for Medigap, the higher the premium you can have.
It offers a great deal of flexibility when it comes to physician network.
Another fantastic advantage is the little efforts it takes to fill a claim. There’s only very little paperwork to deal with, and checks are directed to providers and facilities automatically once Medicare has paid its part of the bill.
Benefits of Medicare Advantage
Medicare advantage plan is an extension of the original Medicare care plan A and B, and it offers more coverage. This option is prevalent because it remains very affordable while replacing the original Medicare plan.
It has lower premiums than Medigap, making it an attractive option if you don’t plan on using it frequently.
Enrolling for Medicare advantage is very simple, and you qualify to join the plan once you are eligible for the original Medicare plan.
Many Medicare Advantage plans also include plan D, popularly known as prescription drug coverage. Medigap, on the other hand, does not include prescription drug coverage; this means the person getting insured must purchase a separate plan for prescription drug coverage.
In conclusion, take time to thoroughly review your medical needs and lifestyle before deciding on the type of plan that will work best for you.
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