Medicare Supplement and Medicare Advantage plans help beneficiaries cover expenses that are not paid by traditional Medicare plans. Nevertheless, the two insurance plans are not the same. Here are four differences you may want to consider when purchasing your plan:
1. Supplemental Provisions
Medicare Supplement plans, which are also called Medigap plans, cover only expenses left over after Medicare has paid. In addition, medical services, such as vision and dental care, that are disallowed by traditional Medicare are not covered by Supplement plans. Prescription drug coverage is also not provided by these plans.
Medicare Advantage plans are designed partially by the private insurers who offer the coverage. Therefore, Advantage plans can offer provisions, such as prescription drug or vision coverage, that are not included by Medicare. Last year, 83 percent of Advantage plans offered drug coverage.
2. Medicare Enrollment
When you purchased a Medicare Supplement plan, you are still an original Medicare beneficiary. Your traditional Medicare plan covers most of your medical bills, and your supplemental plan helps pay for the remaining costs, such as co-payments and deductibles.
Plans included in the Medicare Advantage program do not permit you to remain enrolled in traditional Medicare. The Advantage plan is designed to replace traditional Medicare. It covers the same expenses as a regular Medicare plan, but it is provided through a private insurer.
3. Provider Networks
Any provider who accepts traditional Medicare must accept your Medicare Supplement plan. Thus, the plans can be used to cover remaining expenses from all of your regular Medicare providers. Medicare Supplement plans may not be used to pay provider costs that are not covered by traditional Medicare.
Medicare Advantage plans may only be accepted by a specific network of doctors. Some Advantage plans use PPO networks, which allow you to choose providers who are out of the network for an additional cost. Others restrict you to an HMO provider network. Advantage HMO plans typically have a lower premium.
About 25 percent of traditional Medicare recipients are enrolled in a Medicare Supplement plan. Additional Medicare beneficiaries received supplemental coverage through employment or Medicaid.
In 2014, 30 out of every 100 Medicare beneficiaries were enrolled in a Medicare Advantage plan. In addition, statistics indicate that the number of Medicare Advantage enrollees continues to rise.
Medicare Supplement and Medicare Advantage plans can be advantageous. However, before deciding which coverage is right for you, consider the plan differences and match them to your individual needs. For more information, contact Canopy.Share