Medicare Supplements and Medicare Advantage: The Differences

Will you be eligible for Medicare soon? Are your friends and family trying to educate you on options? Does all the mail you receive and sales calls being made make you want to bury your head and do nothing? What are your options, and what is the difference between the plans you’re being told about?

Original Medicare When you receive your Medicare card with Part A and Part B, you are considering having Original Medicare. This allows you to go to any doctor or hospital that takes Medicare in the United States. In most cases, you will not need a referral to see a specialist.

Medicare Supplements Original Medicare pays for most, but not all, of your healthcare services and supplies needed. Supplements (Medigap), policies that are sold by private insurance companies, can help pay some of those remaining costs. Some supplements cover services that Original Medicare does not cover. Since supplements are standardized and must follow federal and state laws, you have that added protection. The cost for these plans is based on state, age and zip code.

Medicare Advantage These are Medicare-approved plans sold by private insurance companies. They are an alternative to Original Medicare and bundle your Part A and Part B. Many also include your Part D drug coverage. Unlike Original Medicare and a supplement, in most cases, you will need to use doctors and hospitals that contract with these plans and are in their network. Normally, you need a referral to see a specialist. These plans have co-pays, co-insurance and a yearly maximum out-of-pocket limit. The cost for these plans will vary, but some plans do have a zero-premium option.

We understand how choices can be difficult, so give us a call, and we will do our best to educate you so you can make your individual decision.