For most people, the choice between Medicare Advantage and Medicare Supplement depends on three key factors: flexibility, predictability, and extra benefits. Flexibility: If you like to travel or spend part of the year in another state, you need the flexibility to get health care no matter where you are.
Full Answer
How do I choose the best Medicare supplement plan?
You can opt for Original Medicare and supplement it with a Medigap plan and/or a Part D prescription plan, or you can choose a Medicare Advantage plan. Once you’ve decided that you want more coverage than Original Medicare alone, the next step is figuring out which of the many private insurance options will best fit your needs and budget.
What is the difference between Medicare supplement insurance and Medicare Advantage?
With Medicare Supplement insurance, you may need to apply for coverage, and you can be denied under certain circumstances. The two biggest differences between Medicare Supplement and Medicare Advantage are coverage and cost sharing. Medicare Advantage plans do not allow for nationwide coverage.
Should I Choose Medicare Advantage or Original Medicare?
With Medicare Advantage, each plan has its own network, and you may be limited to a much more local or regional area. Original Medicare paired with a Medigap plan and Part D coverage might be the better choice if network size is a concern, or if you expect to travel widely within the U.S. during your retirement.
Do Medicare Advantage plans offer prescription coverage?
Most Medicare Advantage plans ( 89% in 2022) offer prescription coverage via integrated Part D coverage. But if you opt for Original Medicare and a Medigap plan, you’ll need to also purchase a Medicare Part D plan in order to have prescription coverage – Medigap plans sold since 2006 do not include prescription coverage.
What percent of seniors choose Medicare Advantage?
A team of economists who analyzed Medicare Advantage plan selections found that only about 10 percent of seniors chose the optimal Medicare Advantage plan. People were overspending by more than $1,000 per year on average, and more than 10 percent of people were overspending by more than $2,000 per year!
What is the biggest disadvantage of Medicare Advantage?
Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.
What is the benefit of choosing Medicare Advantage rather than the original Medicare plan?
Under Medicare Advantage, you will get all the services you are eligible for under original Medicare. In addition, some MA plans offer care not covered by the original option. These include some dental, vision and hearing care. Some MA plans also provide coverage for gym memberships.
When can you switch from Medicare Advantage to a Medicare Supplement?
Once you've left your Medicare Advantage plan and enrolled in Original Medicare, you are generally eligible to apply for a Medicare Supplement insurance plan. Note, however, that in most cases, when you switch from Medicare Advantage to Original Medicare, you lose your “guaranteed-issue” rights for Medigap.
Why are Medicare Advantage plans being pushed so hard?
Advantage plans are heavily advertised because of how they are funded. These plans' premiums are low or nonexistent because Medicare pays the carrier whenever someone enrolls. It benefits insurance companies to encourage enrollment in Advantage plans because of the money they receive from Medicare.
What are the top 3 Medicare Advantage plans?
The Best Medicare Advantage Provider by State Local plans can be high-quality and reasonably priced. Blue Cross Blue Shield, Humana and United Healthcare earn the highest rankings among the national carriers in many states.
What is the most popular Medicare Advantage plan?
AARP/UnitedHealthcare is the most popular Medicare Advantage provider with many enrollees valuing its combination of good ratings, affordable premiums and add-on benefits. For many people, AARP/UnitedHealthcare Medicare Advantage plans fall into the sweet spot for having good benefits at an affordable price.
Can you switch from a Medicare Advantage plan to Original Medicare?
Yes, you can elect to switch to traditional Medicare from your Medicare Advantage plan during the Medicare Open Enrollment period, which runs from October 15 to December 7 each year. Your coverage under traditional Medicare will begin January 1 of the following year.
Is Medicare Advantage cheaper than original Medicare?
The costs of providing benefits to enrollees in private Medicare Advantage (MA) plans are slightly less, on average, than what traditional Medicare spends per beneficiary in the same county. However, MA plans that are able to keep their costs comparatively low are concentrated in a fairly small number of U.S. counties.
What is the downside to Medigap plans?
Some disadvantages of Medigap plans include: Higher monthly premiums. Having to navigate the different types of plans. No prescription coverage (which you can purchase through Plan D)
Is a Medigap plan better than an Advantage plan?
If you are in good health with few medical expenses, Medicare Advantage can be a suitable and money-saving choice. But if you have serious medical conditions with expensive treatment and care costs, Medigap is generally better.
Can you switch from Medicare Advantage to Medigap with pre existing conditions?
The Medigap insurance company may be able to make you wait up to 6 months for coverage of pre-existing conditions. The number of months you've had your current Medigap policy must be subtracted from the time you must wait before your new Medigap policy covers your pre-existing condition.
What are the benefits of Medicare Advantage?
Medicare Advantage Plans often times come with extra benefits, like free dental cleanings, hearing exams, and eye exams. You could also get a benefit that includes free gym memberships.
Why do people choose Medigap?
For most individuals, a Medigap plan is their top choice because it’s a sure thing. You know exactly how much you’ll pay each year, and it’s predictable. That’s really appealing to a lot of us. But a growing number of people prefer to “pay as they go,” which is the main appeal of a Medicare Advantage plan.
How much is $198 for Medicare Part B?
Private insurance companies. Deductibles and copays. $198 for the year (Medicare Part B deductible) Can be as high as $6,700. Doctor network. No network; you can go to any doctor that accepts Medicare. Limited networks; may have to travel a long distance to see a doctor. Plan benefits.
Can you see a doctor on a Medicare Advantage plan?
The one exception here is a Medicare Medical Savings Account (MSA). This is technically a kind of Medicare Advantage plan, but it’s built very differently. With an MSA, you can see any Medicare-participating doctor, so networks aren’t an issue.
Does Medicare Advantage have a network?
Medicare Advantage plans have networks, similar to what you may have been used to with employer group health insurance plans. However, these networks can be pretty limited, especially if you live in a smaller city. We’ve had clients who had to travel 45 minutes just to see a doctor in their network.
Do you pay less with Medicare Advantage?
There’s a chance you might pay less with a Medicare Advantage plan, especially if you’re healthy , but there’s also a chance that you’d end up paying a lot more, up to your out of pocket maximum. That’s a gamble that some are willing to take, while others prefer the predictability of a Medigap plan.
Is Medicare Advantage the less expensive option?
The handbook suggests that Medicare Advantage is the less expensive alternative – certainly not always true. The handbook fails to explain clearly that Medicare Advantage plans have networks, while those on Original Medicare (and those with a Medigap plan) can see any Medicare-participating doctor.
Does Medicare Advantage have a monthly premium?
Premiums for Medicare Advantage plans vary widely according to the benefits offered by each plan. Some of these plans even offer a limited amount of coverage with no monthly premium.
Does Medigap have the same benefits as Plan N?
Medigap supplemental insurance plans offer standardized benefits across the country. For instance, you’ll receive the same benefits with Plan N regardless of which insurer you buy your Medigap plan from.
What is Medicare Advantage?
Medicare Advantage plans combine the components of Original Medicare — Part A and Part B — into a single plan, while Medicare supplements help pay for costs that Medicare doesn’t cover. Seniors looking for lower costs or better coverage may want to explore their Medicare Advantage options.
What is Medicare Supplement?
Medicare Supplements. Medicare supplements are ideal for seniors who have Original Medicare and need help paying some of their out-of-pocket costs. Known as Medigap insurance, a Medicare supplement covers things like co-payments, coinsurance payments and deductibles.
Does Medicare Supplement cover Medicare Advantage?
It may also cover services that Original Medicare doesn’t cover. A Medicare supplement isn’t a replacement for Original Medicare or a Medicare Advantage plan; it simply supplements the coverage provided by Original Medicare.Medicare supplements are only available to seniors enrolled in Original Medicare. Seniors with Medicare Advantage plans may ...
Does Medicare Advantage have a co-payment?
Some Medicare Advantage plans have $0 premiums, which means a Medicare Advantage plan may help seniors save money every month. Medicare Advantage plans may also have lower co -payments or coinsurance requirements than Original Medicare, which can reduce a senior’s out-of-pocket medical costs.
Does Medicare Advantage have an annual maximum?
Original Medicare doesn’t have an annual maximum, which may make services received under a Medicare Advantage plan more affordable.Another advantage of choosing a Medicare Advantage plan over Original Medicare is that some plans include vision and dental coverage.
Can seniors with Medicare Advantage plan take Medicare supplements?
Seniors with Medicare Advantage plans may not purchase any Medicare supplements. Seniors may want to keep in mind that Medicare supplements sold after January 1, 2006, can’t include prescription coverage. Seniors in need of drug coverage may want to look into purchasing Medicare Part D, a type of Medicare that provides coverage for prescription ...
How much is Medicare Advantage 2021?
In most areas, there are “ zero-premium ” Medicare Advantage plans available (although you still have to pay for Medicare Part B; in 2021, the premium for Part B is $148.50/month for most enrollees ). According to the Kaiser Family Foundation, 96% of Medicare beneficiaries have access to at least one zero-premium Medicare Advantage plan for 2021.
How much does a 65 year old pay for medicaid?
But according to data from eHealth, the average 65-year-old paid $134/month for Medigap coverage in 2020.
What is a SNP in Medicare?
Would you qualify for a Medicare Advantage Special Needs Plan (SNP)? SNPs are geared to the needs of very specific populations, and can be a good choice for people with certain medical conditions, as well as those who are institutionalized or who are Medicare-Medicaid dual eligible.
Does Medicare Advantage have an open enrollment period?
So while Medicare Advantage and Part D have an annual open enrollment period that lets enrollees switch plans, Medigap issuers can use your medical history to determine eligibility and premiums if you’re enrolling after your initial enrollment period.
Is Medicare Advantage guaranteed?
Although Medigap, Part D, and Medicare Advantage are all guaranteed issue for all enrollees during their initial enrollment period, Medigap plans aren’t guaranteed issue after that in most states. So while Medicare Advantage and Part D have an annual open enrollment period that lets enrollees switch plans, Medigap issuers can use your medical history to determine eligibility and premiums if you’re enrolling after your initial enrollment period.
Is Medicare Part D or Original?
Original Medicare paired with a Medigap plan and Part D coverage might be the better choice if network size is a concern, or if you expect to travel widely within the U.S. during your retirement. But if you have a specific provider in mind, do your homework before you pick a coverage option.
Does Medicare cover travel?
Original Medicare doesn’t cover foreign travel except for a few rare circumstances, but most Medigap plans provide some coverage for foreign travel (80% of the cost of emergency care received in the first two months of a trip, limited to a $50,000 lifetime cap, and with a $250 annual deductible). Medicare Advantage plans can cover foreign travel ...
What are the benefits of Medicare Supplement Plans?
One of the benefits of Medicare Supplement Plans is that you have the freedom to choose any doctor or hospital that accepts Medicare. With Medigap, you no longer have to worry about network restrictions.
How does Medicare Advantage work?
For the Medicare Advantage plan, Medicare pays your private insurance company a fixed amount of money annually based on the cost of healthcare in your area. For Medicare Supplement, your monthly premium takes care of most of the expenses.
Do you need pre-approval for Medicare Advantage?
Medicare Advantage Plan requires pre-approvals to get some types of care while for Medigap Plans, you do not require any approvals as long as you qualify for that service through the Original Medicare plan.
Can you cancel Medicare Advantage?
The Medicare Advantage Plan can be cancelled at any time by your health insurance company while your health insurer can not revoke the Medigap insurance unless you default on premium payment.
What are the pros and cons of Medicare Advantage vs. Medigap plans?
Here are some pros and cons of each choice for additional Medicare coverage: Medigap that goes with original Medicare vs. Medicare Advantage, an alternative to it.
Why would you choose a Medicare Advantage over original Medicare coverage?
Medicare Advantage plans combine Medicare Part A (hospital insurance), Part B (medical insurance), and, usually, Part D (prescription drug coverage) in one plan, often for no more than the Part B premium. Many MA plans provide benefits like vision, hearing, and dental care that enrollees don’t get through traditional Medicare.
What are the biggest gaps in Medicare coverage?
Original Medicare doesn’t cover many services important to older adults, such as:
How do you know if you would benefit from a Medigap plan?
Medigap is a supplement to Medicare that helps you cover healthcare copayments, coinsurance, and deductibles from Medicare Part A and Part B. Unlike MA plans, new Medigap policies don’t provide prescription drug coverage.
The bottom line
Medicare Advantage plans bundle Medicare parts together and often offer extra benefits such as dental and hearing care, but they come with limited provider networks and may pose issues if you travel.