Which Medicare plan is right for you, Supplement or Advantage? Here's a breakdown of these Medicare plans. This is Medicare made easy by Jared from MedicareInc.Com.
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I bet you’re looking for a simple, straight-forward explanation to the question: what’s the difference between Medicare Supplement & Medicare Advantage? Today we’re gonna look at the difference between these two plans plus more.
The question we get asked the most is, What’s the difference? Quite a bit! In fact, Medicare knows you’ll have questions, so their solution is to mail you a book every year. Here’s their explanation of Medigap.
“Medicare Supplement (Medigap) Insurance policies, can help pay some of the health care costs that Original Medicare doesn’t cover…If you have Original Medicare (A&B) and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then, your Medigap policy pays its share.”
Ok, so in plain English, what exactly does that mean? It means that Medicare does not offer you full coverage, in fact, Medicare only covers 80% of your bills, leaving you responsible to pay the remaining 20%. This 20% is known as the Coverage Gap. That’s where Medigap comes in. It can cover the entire 20% gap, ensuring you’re a 100% protected. Medigap bridges the gap in Original Medicare by helping to pay for medical expenses that fall under that 20% gap. In other words, Medicare will pay 80% of your medical bills and your Medigap insurance will pay the remaining 20%. It’s really that simple.
Now let’s look at Medicare Advantage or Part C
Medicare Advantage (Part C) is an optional type of Medicare health plan offered by private insurance companies and limited to a local network of Doctors, Hospitals, and Specialists. These companies must follow rules set by the government and the rules can change each year. –Source, Medicare.gov
Ok, pause. You might be asking yourself, Jared, do you mean to tell me that Medicare Advantage has restrictions on how I receive medical care? Simply put, Yes! You see, unlike Medigap, which completes your coverage, if you join a Medicare Advantage plan you’re limiting your freedom of choice and allowing the insurance companies to manage ALL of your health care. They tell you where you can and can’t go, and how much it’s gonna cost you.
With your Red, White & Blue Medicare card, you’re given access to any hospital, doctor or specialist in the entire U.S. who takes Medicare. Think of it like a golden ticket that’s accepted virtually everywhere in the U.S. If you join a Medicare Advantage plan you’re giving up that ticket and allowing the insurance company to limit your health care options. For example, if you’re diagnosed with a terminal illness and you’ve heard nothing but great things about MD Anderson Cancer Center in Texas, your Advantage plan may not allow you access to their facility or doctors, because they’re out of network. Remember, Medicare Advantage limits you to a local network of providers in your general area. So unless you live in Texas near MD Anderson, chances are, with Medicare Advantage, you won’t be covered.
Many Medicare Advantage plans may require you to pay monthly premiums, annual deductibles, co-payments, and co-insurance. They can also charge different out-of-pocket costs up to $6,700 dollars each year. Most Medicare Advantage plans don’t offer coverage outside the US. And they have different rules for how you get services, like whether you need a referral to see a specialist or which doctor will accept your insurance. Hospitals, and specialists frequently leave networks, making it harder to get the care you’re entitled to. Also, it’s important to note that because no one can predict how much care they’ll need from year to year, and with all the out of pocket costs like copays and deductible, Medicare Advantage makes planning & budgeting your annual expenses nearly impossible.
When comparing the two, Medigap plans offer the most protection and remain the most popular choice of coverage for people throughout the U.S. So don’t roll the dice, make sure you’re 100% covered with the freedom to choose how you receive care.
Thank you for watching…if you have any questions about the content of this video or about maximizing your Medicare benefits, then download our free e-book, The Medicare Strategy Guide.