Medicare Open Enrollment | Health Insurance Agent Compares Medicare Advantage to Medicare Supplement
Medicare Advantage (part C) vs. Medicare Supplement (Medigap)
By: Nevada Insurance Enrollment Marketplace
She explains “During this Annual Enrollment Period (October 15th through December 7th), many people may ask the question 'Do I want a Medicare Advantage Plan, or a Medicare Supplement Plan (Medigap)?' To help someone answer that question, they have to know the differences between these two plans to make a good decision.”
Medicare Advantage Plan (Part C)
Shelly states, “Many MA plans have 'Part D' which is prescription coverage built into the plan. A person's prescriptions are covered with these types of MA plans called Medicare Advantage Prescription Drug (MAPD).”
Some Medicare Advantage plans have a $0 premium, some have a small premium. Medicare beneficiaries could still have out of pocket expenses like co-pays, deductibles and may have other costs. Some MAPD plans are HMO, others are PPO. They generally will have a “Network” of doctors and hospitals.
If someone has Medicare Part A and Part B, they cannot be turned down (unless they have End Stage Renal Disease) for a Medicare Advantage plan. They must live inside the insurance plan’s “service area.” Many plans will require their members to select a primary doctor that is charged with overseeing care for that individual.
If a person enrolls into a MAPD plan, their claims are paid by a private insurance company instead of original Medicare. They’ll use their private insurance company’s health card, not their Medicare card when they see their doctors.
Each year the health insurance company offering the Medicare Advantage plan can renew their plans, or can terminate their plans. It is a year to year contract. Medicare Advantage (MA) is a type of health insurance offered by private insurance companies that have been approved by Medicare and are referred to as “Medicare Part C”. These plans are required to offer the same or better benefits as Medicare, but can offer additional benefits too.
Compare Medicare Advantage to:
Medicare Supplement (Medigap)
She explains, “With a Medicare Supplement Plan F, a person won’t have co-pays or deductibles. They only have their premium to worry about each month, keeping their medical expenses predictable. No surprises with medical expenses like copays or deductibles."
Medicare Supplement (Medigap) is private health insurance. It sits on top of Medicare to supplement it. It fills in the “Gaps” of original Medicare. Medicare Supplement plans have a premium associated with them.
A person can choose their own doctors and hospitals that accept Medicare, without having to worry about “Networks”
They can purchase a Medicare Supplement plan (Medigap) any time of the year. The Medicare Supplement plans don’t have certain times of the year when people enroll. They will, however, after they’ve had their Medicare Part B plan for 6 months, need to go through some “Underwriting”
Insurance companies can charge different rates for the exact same Medicare Supplement plan, so it makes sense to shop prices. A Medicare Supplement Plan F with insurance company A will have the exact same benefits for a Supplement Plan F with insurance company B. So shop around and get the best price.
Medicare Supplement plans generally require a separately purchased drug plan. This is important. You’ll pay a penalty if you go without a qualified drug plan.
Please note: It’s important to understand that a person cannot have a Medicare Advantage plan and a Medicare Supplement plan at the same time.
If you have questions, you can contact Shelly personally at (702) 898-0554.
For more information, you can visit her website at:
Page Updated Last on: Oct 15, 2014