Trying to figure out Medicare Advantage vs. Medicare Supplement (Medigap)?
You’re not alone. This is one of the biggest decisions people face when they first enroll in Medicare.
The good news is that the basic difference is actually pretty simple:
Medicare Advantage = lower monthly costs, but more potential out of pocket costs.
Medicare Supplement = higher monthly costs, but more freedom and predictable medical costs.
Not sure which direction is right for you?
I can help you compare Medicare Advantage and Medicare Supplement options based on your doctors, prescriptions, budget and personal preferences. There’s no cost to review your options.
Call Ben at 216-835-1255 or reach out to get started.
Let’s break it down.
Medicare Advantage: Lower Monthly Cost
Medicare Advantage is an alternative way to receive your Medicare benefits through a private insurance company.
Many Medicare Advantage plans have low or even $0 monthly premiums and may include prescription drug coverage, dental, vision, hearing and other extra benefits.
The trade-off is that you generally need to use the plan’s network of doctors and hospitals, and you may have copays, coinsurance and other out-of-pocket costs when you receive care. Some services may also require prior authorization.
Medicare Advantage may be a good fit if you:
- Want to keep your monthly costs low
- Are comfortable using a network of doctors
- Like having additional benefits included
- Don’t mind paying for copays when you use medical services
Medicare Supplement: More Freedom & Predictable Costs
With a Medicare Supplement plan, you keep Original Medicare and the supplement helps pay some of the costs Medicare doesn’t cover.
One of the biggest advantages is freedom to choose doctors. With Original Medicare, you can generally see any doctor or hospital in the U.S. that accepts Medicare.
Medicare Supplement plans generally have a higher monthly premium, but your medical costs can be much more predictable.
You’ll also need a separate Part D prescription drug plan because Medigap plans generally don’t include prescription drug coverage.
Medicare Supplement may be a good fit if you:
- Want the freedom to see doctors anywhere that accepts Medicare
- Travel frequently
- Prefer predictable medical costs
- Don’t want to be restricted to a specific provider network
Medicare Advantage vs. Medicare Supplement
|
Medicare Advantage |
Medicare Supplement |
|
|
Monthly premium |
Usually lower |
Usually higher |
|
Doctor choice |
Generally network-based |
Any provider accepting Medicare |
|
Drug coverage |
Usually included |
Separate Part D plan |
|
Medical costs |
Copays & coinsurance |
Generally more predictable |
|
Extra benefits |
Often included |
Usually not included |
|
Prior authorization |
May be required |
Generally less of an issue with Original Medicare |
So Which One Should You Choose?
There isn’t one right answer for everyone.
The better choice depends on your health, doctors, prescriptions, budget, travel habits and personal preferences.
In simple terms:
Medicare Advantage = lower monthly cost + more potential out of pocket costs
Medicare Supplement = higher monthly cost + more freedom and predictable costs
One important consideration is when you apply for a Medicare Supplement plan. Your Medicare Supplement Open Enrollment Period can provide important protections, so it’s smart to understand your options before making your initial Medicare decision.
Need Help Deciding?
You don’t have to figure it out on your own.
I help individuals compare Medicare Advantage, Medicare Supplement and Part D plans based on their doctors, prescriptions, budget and individual needs.
My service is at no cost to you.
If you’re approaching Medicare or simply wondering whether your current plan is still the right fit, let’s talk.
Call Ben at 216-835-1255 or contact me to review your options.