When you're eligible for Medicare, you have important choices to make beyond original Medicare. Let's compare two popular options: medicare "advantage" plans versus Medicare "supplement" insurance or Medigap. We'll start with Medicare "Advantage," also called Part C. Medicare "Advantage" plans replace your "original" Medicare.
These plans are offered by private insurance companies. Think of them as "all-in-one" packages. Most medicare advantage plans include coverage for all Part A and Part B services. Prescription drug coverage in most cases and "extra" benefits not covered by Original Medicare, like dental care, vision services, hearing aids, and fitness programs.
However, these plans typically have network restrictions. This means you'll usually need to use doctors within the plan's network. You might also need referrals, in order to visit specialists. With Medicare's "advantage," you'll generally pay lower monthly premiums. But keep in mind you'll have more copayments and coinsurance when you actually receive care.
Now, let's talk about "supplement" insurance. Rather than replacing the original Medicare, they work alongside it. These policies help cover costs that Medicare doesn't pay. Medigap plans help pay your deductibles, copayments, and coinsurance from Original Medicare. These plans allow you to use any doctor or hospital that accepts Medicare anywhere in the United States.
No network restrictions apply. You'll need to purchase a separate Part D plan if you want prescription drug coverage. Medigap typically has higher monthly premiums. But it significantly reduces or eliminates out-of-pocket costs when you receive care. Many people appreciate this predictability.
When making your choice, consider your health needs, budget, whether you travel frequently, and how important provider flexibility is to you. Remember: You can't have both Medicare "advantage" and Medigap at the same time. You can only have one or the other.
To summarize, medicare "advantage" plans often cost less upfront but may result in more costs when you receive care. Medigap plans offer more comprehensive coverage with higher predictable monthly costs but less surprising bills. Check out all of our Medicare tips here on SeniorTopia and if you have more questions, contact me at 858 - 722 - 8505.
