If you are new to Medicare, you might have heard of the terms Medicare Supplement Plans and Medicare Advantage. You might wonder, “what does each entail, and which is best for me?” You have come to the right place. In this article, you’ll learn the features of each plan and how you can settle on the best one depending on your needs. Take a look!
Medicare Supplement Plans
Medicare Supplement Plans are also referred to as Medigap Plans. Private insurance companies sell these plans to cover the gaps in Original Medical coverage.
If you want a Medigap plan, you can choose from ten available options that will help cover deductibles, coinsurance, and copays.
Eligibility for Medicare Supplement Plans
There is a six-month open enrollment period which begins on the first day of the month you are over sixty-five. You can get a Medicare Supplement plan without medical underwriting during this window. Medicare Supplement plans eligibility criteria may vary from state to state. Some require insurance companies to sell policies to people under sixty-five, while others don’t. Some companies might not sell you the policy if you are older than that. Others might charge you more, make you wait a little longer for coverage to start, or ask for your medical history.
How Much Do Medicare Supplement Plans Cost?
Costs for the Medicare Supplement plan depend on the state you live in and on your insurance provider. Typically, they might range from $150 to $200 in monthly premiums.
A Few Things To Note About Medicare Supplement Plans
- You need to have Medicare Part A and Part B
- The policy only covers one person–even spouses need separate policies
- An insurance company cannot cancel your policy as long as you pay the premium
- An insurer cannot sell you a Medicare Supplement plan if you have a Medicare Advantage Plan.
Medicare Advantage Plans
Now that you understand the ins and outs of the Medicare Supplement plan, let’s move on to Medicare Advantage plans. These plans are also known as Part C plans. Unlike Medigap, Medicare Advantage aims to replace Original Medicare as the primary insurance. Besides covering Original Medicare benefits, they might also cover extra items like dental, vision, hearing, and fitness. In most cases, Medicare Advantage benefits will also include prescription drug coverage. However, there might be restrictions regarding your choice of doctors, hospitals, and procedures.
With Medicare Advantage Plans, you can choose from over thirty options. However, the availability of these options may vary depending on your location.
Eligibility for Medicare Advantage Plans
You qualify for Medicare Advantage if:
- You are sixty-five or older
- You are a young person with disabilities
- You have an end-stage renal disease
With this plan, you also need to be enrolled in Medicare Part A and Part B. Usually, enrollment begins three months before you turn sixty-five and runs until three months after you turn sixty-five. That gives you a six-month window. Besides the initial enrollment period, you join or switch to a Medicare Advantage plan during these windows:
- Open Enrollment Period – Between October 15 and December 7
- Medicare Advantage Open Enrollment Period – January 1 to March 31 each year
How Much Does It Cost?
In many cases, Medicare Advantage plans have a $0 premium, but be sure to shop around before settling. If you have a premium, you must pay it on top of your Medical Part B premium.
Which One Is Better for Me?
Deciding between a Medicare Supplement and Advantage plan boils down to your unique needs. For instance, if you prefer having your coverage rolled into a single plan, you might find a Medicare Advantage plan ideal. An Advantage plan might also be beneficial if you need coverage for disabilities or long-term care facilities.
On the other hand, if your biggest concern is getting protection from unexpected out-of-pocket expenses, then a Medicare Supplement plan might be the way to go. Similarly, you might consider getting a Medicare Supplement plan if you don’t want restrictions on your choice of doctors or facilities.
Ultimately, it all boils down to your unique needs and preferences. Ask your doctor and your current insurance company what would work best for your case. That way, you can ensure that your healthcare needs are being met without breaking the bank.