medicare advantage vs supplement
Medicare Advantage
- Pay as you go healthcare (each service typically costs a small to large copay)
- Includes Part C & Prescription Drugs
- Medicare Advantage plans often include coverage beyond what is offered by Original Medicare (Part A and Part B). Instead of being administered by the government, Medicare Advantage plans are offered by private insurance companies that are approved by Medicare. These plans must cover all the services that Original Medicare covers, but they may do so with different costs and restrictions.
- Medicare Advantage plans can change their coverage and costs each year, so it's crucial to review your plan annually and consider switching if necessary.
Medicare Supplement
- Prepaying for your healthcare (cannot pay anymore than your monthly premium)
- Does not include Part C Benefits
- A PDP Plan must be picked up on the side – Dental Hearing and Vision are often times paid out of pocket
- Medicare Supplement, also known as Medigap, is a type of private health insurance designed to supplement Original Medicare (Part A and Part B). Medigap plans are offered by private insurance companies and can help pay for some of the healthcare costs that Original Medicare doesn't cover, such as copayments, coinsurance, and deductibles.
- Medigap plans are standardized, meaning they are labeled with letters (A, B, C, D, F, G, K, L, M, and N) and offer the same basic benefits regardless of the insurance company. However, not all plans may be available in every state. While the coverage is standardized, premiums can vary among insurance companies. It's essential to compare plans and shop around to find the best combination of coverage and cost for your needs.
Part D
- Medicare Part D plans are offered by private insurance companies that are approved by Medicare. These plans provide coverage for prescription medications and are designed to work alongside Original Medicare (Part A and Part B) and Medicare Advantage plans.
- Part D plans offer a range of prescription drug coverage options. Each plan has a formulary, which is a list of covered drugs. It's important to choose a plan that covers the specific medications you need. Part D plans typically have monthly premiums, annual deductibles, and cost-sharing in the form of copayments or coinsurance. The costs can vary widely among plans, so it's important to compare plans to find one that fits your budget and meets your prescription needs.
Part D Penalty
- Part D Penalty: If you don't sign up for a Medicare Part D prescription drug plan when you're first eligible and you don't have other creditable prescription drug coverage (coverage that is expected to pay, on average, at least as much as Medicare's standard prescription drug coverage), you may have to pay a late enrollment penalty if you join a plan later.
- Part B Penalty: If you don't sign up for Medicare Part B during your initial enrollment period and you don't have other creditable health coverage (coverage that is expected to pay, on average, at least as much as Medicare's standard coverage), you may be subject to a late enrollment penalty.