Medicare Supplement vs. Medicare Advantage
Once you are enrolled in Medicare Part A & Part B, you have choices of additional coverage. These reduce your portion of Medicare’s Cost Sharing. Cost Sharing is how much it costs you to use your Medicare plan with doctors, hospitals and other medical providers. This applies after Medicare pays their portion.
Do you have to get additional coverage? No. If you don’t, you work directly with Medicare and can see any doctor anywhere in the United States that takes Medicare. Medicare pays their portion of the cost and you pay yours. There are many costs that you are responsible for. Hence, insurance companies have come up with plans that cover some of these costs. They are Medicare Supplement Plans (aka Medigap) and Medicare Advantage Plans (aka Medicare Part C). When comparing a Medicare Supplement vs. Medicare Advantage it’s important to know they’re not the same.
What is a Medicare Supplement plan?
A Medicare Supplement plan is coverage issued by an insurance company. It is accepted by any doctor (or other facility) anywhere in the United States that takes Medicare. A variety of Medicare Supplement plans are available that pay for part or all of your cost-sharing. An F Plan Medicare Supplement is the most comprehensive coverage you can buy. With an F Plan you won’t pay any costs at all, as long as it is a Medicare approved expense and Medicare pays their portion.
A Medicare Advantage plan is coverage issued by an insurance company that is accepted only by doctor’s in-network (those on a specific list of providers). This network is usually a HMO with local providers. You cannot go to any doctor anywhere that accepts Medicare. A variety of Medicare Advantage Plans are available that pay for some or most of your cost-sharing, with and without Deductibles.
How much does a Medicare Supplement vs. Medicare Advantage Cost?
Prices for Medicare Supplement F Plans vary by insurance company, but you can expect a range of about $140-$220 per month at age 65. Like Medicare, Medicare Supplement plans pay for medical expenses only. They do not have coverage for Prescriptions, routine dental or routine vision. If you want coverage for those you have to buy separate plans. Prescription plans can cost $25 to over $100 per month, depending upon your needs. Dental with Vision plans typically run $20 to $70 per month, depending upon the amount of benefits you want in your plan.
Prices for Medicare Advantage Plans vary by insurance company and are typically much less than an F Plan, usually costing zero dollars to $50 or more depending upon the amount of benefits you want in your plan. However, many Medicare Advantage Plans include good Prescription plans with some coverage for Dental and Vision built in, at no extra cost.
Medicare Supplement plan vs. Medicare Advantage Plan Open Enrollment
Open Enrollment, a time during which you can purchase and not be asked medical questions, also vary.
- For Medicare Supplement Plans you get six months once you’ve enrolled in Part B and are at least 65 years old. After that, they can ask medical questions and you can be denied or charged more for medical conditions.
- For Medicare Advantage plans you get an Initial Enrollment Period once you are enrolled in A & B and then annually each year during the Open Enrollment Period (October 15 – December 7).
There’s a lot more. A thorough needs analysis is the best way for us to figure out which type of plan is best for you. I do this for all my clients without cost to them. If you need help comparing Medicare Supplement vs. Medicare Advantage please give me a call.
Jake Young, 775- 828-1216
Individual and Family Specialist since 2002