Medicare Supplements and Medicare Advantage plans differ in the coverage they offer, the providers you can see, the way they handle out-of-pocket costs, and the way you enroll. At Malhotra & Assoc. Insurance, we know how important it is that you understand these key differences. That is why our highly knowledgeable insurance experts are here to help!
Coverage
Medicare Advantage and Medicare Supplements are fundamentally different, and this is most apparent when you look at the coverage options between these plans.
Medicare Advantage plans are an alternative to Original Medicare. They bring you the same coverage offered in Medicare Part A and Part B, just through a private insurance company. Often, these plans have additional perks or benefits to entice you, which can include things like fitness club memberships. Medicare Advantage plans can also provide prescription drug coverage.
Medicare Supplements are a separate policy that does not cover your health needs; instead, these help you pay for the out-of-pocket expenses from Medicare Part A and Part B. Medicare Supplements can help you pay for things like the Part A deductible, coinsurance, copayments, hospital costs, hospice care, skilled nursing facility care, and more.
Providers
Medicare Advantage plans usually operate with networks of healthcare providers in your region. You may have to switch primary care providers if they are not part of your plan’s network.
Medicare Supplement plans work with Original Medicare. That means that you can see any provider that accepts Medicare.
Out-of-Pocket Maximums
Both Medicare Advantage and Medicare Supplement plans help you control your out-of-pocket spending, but they do this in different ways.
Medicare Advantage plans have a built-in safeguard to protect you from spending too much toward your healthcare. Every Medicare Advantage plan is required to have an out-of-pocket maximum to limit your spending.
Medicare Supplements are specifically designed to help take care of your out-of-pocket costs.
The ten available plans cover different combinations of coverage for your copayments, coinsurance, and Part A deductible, reducing your healthcare spending.
Enrolling in Medicare Supplements vs. Medicare Advantage
An important difference between Medicare Supplements and Medicare Advantage plans is how you sign up for them. You cannot have both a Supplement plan and an Advantage plan. You either have Original Medicare and can choose to add a Medicare Supplement policy or you can enroll in Medicare Part A and Part B then switch to a Medicare Advantage plan.
You can enroll in a Medicare Advantage plan if you are enrolled in Medicare Part A and Part B and live within the plan’s service area. These plans need to be renewed every year, so you have the chance to switch policies every fall. You can easily return to Original Medicare or switch plans during the Open Enrollment period.
The best time to enroll in a Medicare Supplement plan is during your Medigap Open Enrollment. This lasts for six months and begins once you are first enrolled in Medicare Part B. During that time, you can purchase a plan without having to go through medical underwriting. Insurance providers are not required to offer these plans to people under age 65, so you may encounter higher premiums if you are not of that age.
Choosing Between Medicare Advantage and Medicare Supplements
The choice between these two Medicare options can come down to your budget and your anticipated health care needs. If you choose a Medicare Advantage plan, shop around for a new policy every year to make sure you have the best coverage available. With a Medicare Supplement plan, choose a plan with affordable premiums that will cover a decent amount of your out-of-pocket costs.
For assistance in choosing between Medicare Advantage and Medicare Supplement plans, contact Malhotra & Assoc. Insurance. Our team of experts will help you find a plan tailored to your best interests.
