Supplements vs. Advantage plans, Which is Best for you?
Advantage Plans (Part C of Medicare)
Supplement Plans (Medigap)
|Cost – As little as $0 to $315 per month||Cost – Normally between $95 to $175 per month. In addition, you normally would want to purchase a separate prescription plan (Medicare Part D) which costs about $15 to $45 per month.|
|Coverage – All companies must offer the same 29 categories of benefits. The only difference between companies is what you pay monthly and what your co-pays, co-insurance, deductibles, and maximum out of pocket costs are. Coverage is based on co-pay and co-insurance schedule and is broken down in summary of benefits.||Coverage – Pays almost everything that Medicare Parts A and B do not cover.|
|Benefits – (1) Low cost. (2) No underwriting. Everyone is accepted unless they have End Stage Renal Disease. (3) Possibly allows you to get vision, hearing, and limited dental benefits. (4) Plans can include Part D prescription coverage provided in the policy.||Benefits – (1) Very easy to understand. You pay premiums and almost nothing else. There are no doctor co-pays, surgical co-pays, ambulance co-pays, skilled nursing facilities co-pays, etc. (2) You have the right to go to any doctor or facility in the country that accepts Medicare Assignment. Regardless of the company providing coverage, the doctor or hospital must accept it. (3) Benefits rarely, if ever, change. This means you will always have little or no out of pocket expense.|
|Negatives – (1) You must get your care from participating doctors, facilities, and hospitals. (2) Rates can increase year to year. We have seen increases on plans as high as 300%. (3) benefits can change year to year, often resulting in higher co-pays and out of pocket expenses. (4) You may have some potentially higher out of pocket costs in some areas like skilled nursing facilities, durable medical equipment, chemotherapy drugs, prosthetic devices, and hospitalizations. (5) Once enrolled in an Advantage Plan it may become impossible or unaffordable to enroll in a Supplement Plan. It is extremely important that you understand the difference between an Advantage Plan or Supplement Plan, such as Medigap, as the decision you make can affect you for years to come.
|Negatives – (1) Generally more expensive than Advantage Plans. The premiums tend to increase as you get older and can get as high as $300 per month if you live to your 80s or 90s. (2) No vision, dental, or hearing benefits. These will need to be paid entirely out of pocket. (3) These plans can be medically underwritten.|
If you want to sign up for a Medicare Supplement or Medicare Advantage health insurance plan, feel free to call 724-603-3403 or email us a quote request!