What Are the Differences in a Medicare Advantage Plan vs a Medicare Supplement Plan?
The agents at The In Group are often asked “What is a Medicare Advantage Plan” and “What is a Medicare Supplement Plan? and is one better than another?
Below we will give a brief overview of each and answer these questions.
What is a Medicare Advantage Plan?
A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits.
Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.
If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare.
Most Medicare Advantage Plans also offer prescription drug coverage.
What do Medicare Advantage Plans cover?
Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you’re in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you’re always covered for emergency and urgently needed care.
Medicare Advantage Plans may offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan.
You can also ask the plan for a written advance coverage decision to make sure a service is medically necessary and will be covered. If the plan won’t pay for a service you think you need, you’ll have to pay all of the costs if you didn’t ask for an advance coverage decision. Get your plan’s contact information from a Personalized Search (under General Search), or search by plan name.
What is Medicare Supplement Insurance (Also known as Medigap)?
Medicare Supplement (Medigap) insurance can help pay some of the health care costs that original Medicare does not cover. These additional costs include copayments, coinsurance, and deductibles.
Some Medicare Supplement Insurance policies also offer coverage for services that Original Medicare doesn’t cover. This could include medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medical Supplement Insurance policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medicare Supplement insurance policy pays its share.
A Medical Supplement Insurance policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.
Important Things to Know About Medicare Supplement Coverage
- If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
- You pay the private insurance carrier a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.
- A Medigap policy covers one person. If you and your spouse both want Medigap coverage, an In Group Agent will work with you to setup two separate policies.
- Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.