Why it’s important to know your needs, your provider preferences, and your travel expectations before choosing a plan.

The difference between Medicare Advantage and Supplement plans can be confusing. They are very different yet have some similarities. Which is best depends on your specific needs. So let’s dive in!

Navigating the Medicare system can be confusing, with a wide variety of plans offering very different types of coverage. Medicare Parts A and B are public options, Part A covers hospital visits, nursing home care, and home health services, and Part B covers things like doctor’s appointments, medical devices and equipment, and preventative testing. Part C, Medicare Advantage, and Medicare supplements, often referred to as Medigap, are plans run by private health insurance companies.

While both Medicare Advantage and supplement plans offer benefits above and beyond what a Medicare Part A or B plan will cover, they operate very differently. Advantage plans can actually have lower premiums and copays than government-run A or B plans, but if you enroll in an Advantage plan, you cannot enroll in a supplement plan as well.  In order to buy a supplement plan, you must already be enrolled in Medicare Part A. Supplements fill in the coverage “gaps” of Part A and B plans. According to a study by the American Association for Medicare Supplement Insurance (AAMSI), approximately 14.5 million U.S. citizens were enrolled in Medicare supplement plans in 2020. Illinois has one of the highest enrollment rates, at about 35%.

Determining what type of plan is right for you is a very personal decision. If you want more freedom over what doctors you can see, you may want to explore supplement plans. Medicare Advantage plans often require that you see providers within their network, and if you see an out-of-network provider, you could be paying far more than expected. However, if your preferred providers are in-network for a given Medicare Advantage plan, you could save on both premiums and copays at the doctor’s office.

An advantage of Medicare supplements is that they can cover Part B costs, as well as deductibles from Part A plans that would otherwise have to be paid out-of-pocket. If you travel internationally on a regular basis, supplement plans can also cover emergency care in other countries. While supplements come with these benefits, along with many others, one drawback is that they do not offer prescription drug coverage. If you are enrolled in Medicare Parts A and B and a supplement plan, you would have to enroll in Part D as well to cover medication. 

While both Medicare Advantage plans and Medicare supplement plans have advantages and drawbacks, it can be very difficult to decide what path is right for you. Mark Dupre at the MLD Agency has over 30 years of experience making sense of Medicare and is a trusted partner to his clients. If you are having a hard time determining what plans are best for you, contact the MLD Agency to find out how Mark and his partners can help you today.

To watch the video version of this blog check out my YouTube channel.

by Elizabeth Clay of Clay Creative Content