Your Medicare Options
What is the difference between a Medicare Supplement Plan(Medi-gap) and a Medicare Advantage Plan(Part C)?
MEDICARE SUPPLEMENT PLANS
‘Medi-gap’ plans, are used only by people enrolled in original Medicare. Medicare Supplement plans are designed to cover some, or most of your out-of-pocket expenses that traditional Medicare does not pay. Supplements generally cover the twenty percent that Medicare A and B do not cover. The Supplement plan may also include coverage for the Part A hospital deductible ($1,364.00 in 2019) Part B co-insurance and co-payments, medical emergencies abroad, and certain other benefits based on the plan you choose. Each Medicare Supplement plan is standardized by law. The benefits of each plan are identical depending on the letter of the plan you choose. Regardless of which insurance company you select for the Supplement, the coverage from each lettered plan is the same. Medi-gap plans are accepted nation-wide by any provider who accepts Medicare. If the doctor or hospital takes Medicare, the Supplement plan must be accepted as well. Medicare Supplement plans do not include prescription drug coverage. A stand-alone Medicare Part D drug plan is required to cover prescription medications. The three most popular plans in the Medicare Supplement market are Plan F, Plan G, and Plan N.
MEDICARE ADVANTAGE PLANS
‘Part C’ of Medicare, this option provides a replacement plan for Original Medicare. These plans must cover the same benefits that traditional Medicare covers. However, the Part B premium of $135.50 per month (depending on your income) will no longer go to Medicare. It will go to the Medicare Advantage plan you select. Medicare Advantage plans can vary in their charges, co-pays, and annual maximum out-of-pocket expenses. Some plans charge a monthly premium on top of Medicare, and many plans can include prescription drug coverage. By law, all plans have annual limits on out-of-pocket costs. The maximum out-of-pocket charges can be as low as $1,000.00 per year or as high as $6,700.00 per year. It will fluctuate based on the company and plan you chose. A major difference from the traditional Medicare program is that most Part C plans are network confined plans. You are required to see doctors and hospitals in that plan’s specific regional network. Failure to stay in network could result in out of network charges.
At the end of the day the main difference between a supplement plan and an advantage plan comes down to cost. Supplements are typically more expensive monthly, but have little to no out-of-pocket expenses. You can go to any doctor or hospital in the country that accepts Original Medicare, but prescription coverage is not included. Where with advantage plans they are typically cheaper monthly, but have thousands each year in out-of-pocket expenses and you are typically confined to a regional network of doctors and hospitals, or you could face out of network charges. However, most, not all advantage plans include prescription drug coverage. For more information and pricing please click on the phone number in the top right corner, or send us an email at firstname.lastname@example.org.
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