Comparing Medicare Advantage & Medicare Supplement Plans
When Comparing Medicare Advantage & Medicare Supplement Plans for those 65 and it is important to understand the many major differences between the two plans. Some Medicare Advantage plans provide additional benefits such as prescription drug coverage, which are not part of original Medicare. Medicare Advantage plans provide benefits in several ways. An HMO or health maintenance organization which allows you to choose your primary care physician from a network of doctors and facilities, a PPO or preferred provider organization which is a network of providers but does not require that you choose a specific physician to coordinate your care and provides more flexibility in receiving out-‐of-‐network care and Private Fee-‐for-‐Service or PFFS. This plan does not limit you to any networks but also does not provide a guarantee that a physician or hospital will accept your plan. Medicare consists of four parts: A, B, C and D.
How Does Obamacare Affect Medicare & Seniors?
- Medicare Part A covers Hospital Insurance, including inpatient care, and skilled nursing, hospice, and home health care to a certain extent.
- Medicare Part B covers necessary medical services such as outpatient care and doctor services as well as some preventative services needed to maintain your health
- Medicare Part C is a Medicare Advantage Plan managed by private insurance companies approved by Medicare. The plans cover the services offered in A and B, although these plans have co-payments, coinsurance, and deductibles.
- Medicare Part D assists with payment for prescription drugs and may help lower your prescription drug costs.
Original Medicare consists of Part A and Part B. However, these may not provide comprehensive coverage. You can fill the gaps in coverage with Medicare Advantage or a supplemental insurance plan called Medigap.
here are twelve different kinds of supplementary insurance plans available for Ohio residents. We can help you find a Medicare Advantage Plan or Medigap Plan that will help cover your co-insurance, co-pays and deductibles. One Source Benefits has years of experience in the industry and is associated with leading insurance companies approved by Medicare. We can help with
- Information on when to enroll for a Medicare Advantage Plan or Medigap Plan
- Filling gaps in coverage such as prescription drug coverage, extended hospital stays or long-term care, specialized in-home care, and more
- Comparing the costs and benefits of each type of supplemental insurance plan
- Choosing or changing plans
Understanding Ohio Medicare and making sure that you get the coverage you need is not easy. We can help you resolve these issues. Take advantage of our knowledgeable and friendly service available through telephone, online chat and e-mail, and ensure that you enjoy peace of mind in your retirement.
One Source Benefits is the industry’s leading provider of affordable Medicare products. Click the logo below for your free quote!
Facts about Medicare Advantage Plans and Medicare Supplement Plans
Medicare Advantage Plans take the place of Medicare Part A and Part B while you are enrolled in the plan. You do not lose Medicare. If you change to a Traditional Medicare Supplement, your Medicare Part A and Part B become primary. Medicare Advantage Plans cover above and beyond what Original Medicare covers. Many plans include the Medicare Part D prescription drug benefit at no additional cost. Many plans have $0 monthly premium options that include the prescription benefit. These options vary by insurance carrier. Insurance carriers receive money from Medicare each month for each individual enrolled in a Medicare Advantage Plan and because of this, many plans have monthly costs as low as $0.
Medicare Supplement Plans help cover expenses not covered by Original Medicare. You must have Medicare Part A and Part B to be eligible. You will always have to pay the Medicare Part B premium. A Medicare Supplement plan is a cost in addition to your Medicare Part B premium. Rates vary by age. Depending on which plan you chose you may or may not have any deductibles to meet prior to coverage beginning. Medicare and the insurance company will cover cost above these deductibles for doctor and hospital expenses. Part D prescription coverage has a monthly cost in addition to the Medicare Supplement and will vary in cost per month based on the insurance carrier chosen. The Part D drug benefit helps to lower the monthly out-of-pocket expense for prescription drugs.
You should speak to a qualified agent with any and all questions regarding Medicare.
Top Questions asked about Medicare Advantage Plans and Medicare Supplements
- Can I use my own doctors and hospitals?
There is a network of doctors with Medicare Advantage Plans and the co-pays are lower if you use in-network doctors. By paying a slightly higher co-pay, you can use any doctor that accepts Medicare, even if this doctor is not in network.
- Will I be covered in other states when traveling in the United States?
Yes. Many insurers cover you with in-network co-pays and allow you to travel in all 50 states with coverage, if you have a Medicare Supplement plan. Medicare Advantage plans probably NOT.
- What is the monthly cost?
Your cost will be based on age with a Medicare Supplement. The cost of a Medicare Advantage Plan will vary on the insurance company you choose. The monthly cost can range from $0 per month and up.
- Do I lose Medicare if I enroll in a Medicare Advantage Plan?
No. You do not lose Medicare. Your Medicare is replaced by the Medicare Advantage Plan while you are enrolled. You have to have Medicare Part A and Part B to qualify for these plans. You will continue to pay your Medicare Part B premiums while on the Medicare Advantage Plan even if the Medicare Advantage Plan has a $0 premium per month.
- Is preventive care covered?
Yes they are covered on the Medicare Advantage Plans. Many of these services have no co-pay.
- Does the premium go up every year?
Medicare Supplement Plans can go up each year. You will be notified in sufficient time of the increase. Medicare Advantage Plans can vary in premium each year. You would be notified during the Open Enrollment Period each year as to any changes for the 1st of the next year. Ask your representative to explain Open Enrollment.
- What is Part D and how much does it cost and how much does it cover for my prescription drugs?
Medicare Part D prescription coverage covers your medications with co-pays. Medicare Supplement Plans require you to purchase the Medicare Part D coverage separately or not at all. The costs and co-pays will vary with each insurance company. Medicare Advantage Plans are designed with the Medicare Part D cost and coverage included. You can purchase a Medicare Advantage Plan without Part D coverage as well. In either case, you should discuss the Medicare Part D options with a qualified representative so the proper fit for your drug coverage needs are met in scope and in cost.
- Can I change plans anytime I want?
Maybe. If you are considering a change in current coverage you should definitely contact your agent to know your options. Not all plans can be dropped at any time. Be sure to ask this question prior to purchasing your plan.
- When does my coverage start?
If you are turning 65, your plan will start on the 1st day of the month of your 65th birthday regardless of what day in the month your birthday actually falls (unless your birthday is actually the first day of the month. In that case your Medicare eligibility is the month prior to your birthday month). Other start dates are the first day of the month you have chosen to start your coverage.
- Can my spouse and I get on a plan together?
No. All Medicare Plans are for individuals. It is different for those who are 65 and married and being covered by a group plan. These people can be on a plan together because the coverage is through their employer. When people come off group plans and are Medicare eligible, they will be required to purchase individual plans.
What’s the difference between Medigap/Medicare Supplemental Plans and Medicare Advantage Plans?
Medigap plans are designed to provide coverage for healthcare expenses that are not covered by Medicare parts A & B. There are 10 standardized Medicare Supplement plans in all states but Wisconsin, Massachusetts, and Minnesota. These plans have different combinations, benefits and deductibles but do not offer prescription drug coverage. Prescription drug coverage can be added with Medicare Part D. Medigap plans are standardized and uniform in the 47 states that offer them. Depending on the plan type (A-‐N) you will receive the same benefits regardless of what insurance carrier you purchase them from. However, with Medicare Advantage plans all benefits offered through the plans not only meet all the A and B benefits but in most cases offer more coverage and benefits than you would get if you simply had A & B coverage. Helpful Medicare Advantage Links