Thursday, February 17, 2011

Medicare Supplement ~Medicare Advantage Plan, That is the Question

Medicare Supplement ~Medicare Advantage Plan, That is the Question

Question: What is the difference in a Medicare Supplement and a Medicare Advantage plan?

Answer: Day and Night! Control and choice are the biggest differences. You have more control and choices with a Medicare Supplement than you do with a Medicare Advantage plan.

A Medicare Supplement works with your Medicare A and B and pays the Medicare approved charges not picked up by Medicare. You may use any doctor or facility you choose. Plan F is the favorite plan and covers 100% of charges not picked up by Medicare. Medicare Supplements are regulated by the federal government and all plans must offer the same benefits (with a few exceptions in a couple states – not Texas). Insurance companies may charge whatever they choose for the different plans, so costs vary.

A Medicare Advantage plan takes the place of your Medicare A and B. When you enroll in a Medicare Advantage Policy, you assign your Medicare A and B to that plan. As long as you are enrolled in the plan, you do not have the option of using just your original Medicare. Some plans allow you to go out of network for a higher cost share but many plans pay nothing if you go outside the plan network. You are responsible for the total out of network bill except in emergency situations. You MUST use the doctors and facilities in an Advantage plan’s network to see the full benefit in cost savings. If you are considering a Medicare Advantage Plan, be sure your doctor and a convenient hospital are in the plan network. Some Advantage Plans include drug coverage and other benefits like vision, dental and hearing plans. The services of these additional benefits are limited.

Costs of both types of plans can vary. Some Advantage plans do not charge a premium to be enrolled in their plan. If you are old enough to be on Medicare, you probably know by now there is nothing completely free, especially in health care. In many instances a Medicare Supplement Plan N is competitive in premium with an Advantage plan.

I use the analogy of driving your own car – the Medicare supplement option, (you can go when and where you would like) versus taking public transportation – the Medicare Advantage option, (it can get you there often for less money but will be less convenient).

Both Medicare Supplements and Medicare Advantage plans have their place. It is important to do your homework and understand either type of plan before you enroll.

SOURCE: , Medicare and You, 2011 Handbook