Understand the difference between Medicare Advantage and Medicare Supplement Plans

What are Medicare Advantage Plans (Medicare Part C)?

The insurance organizations that have the approval of Medicare, provides Medicare Advantage plans. They provide benefits of Part A and Part B plans with an exception of Hospice care.

What are Medicare Supplement Plans (Medigap)?

The private insurance organizations offer these plans. They cover some health care costs not covered by Original Medicare, like deductibles, premiums, and copayments.

How to choose between the two?

One must always compare the advantages, benefits, and costs in relevance to one’s present health conditions and healthcare requirements. While comparing consider, the following factors:

  • Monthly Premiums
  • Deductibles
  • Predicted healthcare and hospital services costs, often used by oneself
  • Plans network of doctors, hospitals, and pharmacies.
  • Prescribed drugs required on regular basis
  • Maximum expected out-of-pocket expenses.

Can one avail both the plans?

No, both of them cannot be availed together as Advantage plans do not operate with Medicare Supplement plans. Hence, one cannot make the payment of Part C Medicare Advantage plan using Supplement plan to cover copayments, premiums, or deductibles.  

A comparative chart study:

Benefits Medicare Supplement Plans Medicare Advantage Plans
Doctors – Hospitals Freedom to choose any doctor and hospitals, if they accept Medicare patients. One may need to choose doctors or hospitals only from the plan network.
Referrals One can consult specialists even without any referrals. Referrals may be required and may need to consult specialist covered in the network only.
Network It does not confine to any area, hence, it works across the United States of America. Network restrictions are likely to be present. However, it covers emergency care during travel within the United States of America and in some cases abroad also.
Enrolling After attaining the age of 65 years or older anyone can purchase a supplement plan and enroll in Medicare Part B plan. One can enroll or switch to another Medicare Advantage plan in the specific periods of the year only.
Costs In addition to Part B premium, monthly plan premium is also paid. It limits the out-of-pocket costs at the time of using services. In general, there is no requirement or a very low monthly plan premium is required to pay against Part B premium. At the time of availing services costs like, co-pays, co-insurance, and deductibles need to be paid.
Prescription Drug Coverage Prescription drug coverage is not included, can also enroll in Medicare plan Part D. Prescription drug coverage is included with most of the plans.






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