Compare Medicare Supplement Insurance 

 

Compare Medicare Supplements to Medicare Advantage Plans

If you are currently enrolled or soon to be enrolled in Medicare Parts A and B, you usually have two choices as to the best way to supplement your government provided benefits.

Original Medicare A and B have several benefit gaps and will not cover all out of pocket expenses now or in the future.

You could choose to go without any supplemental insurance, but the out of pocket risks associated with this decision are substantial.  For the sake of this article, we'll say that you are deciding between an Advantage plan and Medicare supplement coverage.

Compare Medicare Part C Coverage Options

Not to be confused with Plan C (which is an actual Medicare supplement) Part C is one of the four parts of Medicare and is the generic term that includes all privately sold Advantage plans available for purchase.  (The 4th piece of the puzzle is Medicare Part D and refers to stand-alone prescription drug plans.)

Part C includes only Advantage plans and they are private insurance programs usually purchased from providers like Aetna, Anthem BCBS,  AARP United Healthcare and Humana among many others.  Several companies offer both traditional supplements and Advantage plans direct to consumer through independent agents like us.

Thus, when you compare Medicare supplements to Medicare Advantage (MA) plans, you are simply comparing Part C coverage to Medicare supplements and trying to determine a suitable and affordable way to cover the insurance gaps not covered by Medicare.  It is important to note that you cannot be enrolled in both an Advantage plan and a Medicare supplement at the same time.  It is either one or the other.

Compare Medicare Supplements to Medicare Advantage Plans

Benefits Medicare Supplement Medicare Advantage Plans

Monthly Premiums

Usually higher Especially for plans C, D, F & G

Usually lower than most Medicare supplements

Potential For Out-Of-Pocket Expenses

Less Plans C, D, F, G, N and others offer more comprehensive coverage with less out of pocket exposure

Greater Especially for prolonged illness or serious accident/injury; deductible, copays and coinsurance can add up over time

Yearly Deductibles?

Less Most plans cover all Medicare deductibles (Plan F) but deductibles are small

Yes Varies from plan to plan; inquire about maximum out-of-pocket expenses

Choice Of Doctors & Hospitals

Yes Insured can use any doctor or hospital accepting Medicare

No Insured must stay In-Network to realize most savings from the insurance

Includes Part D Rx Coverage

No Part D coverage must be purchased separately

Yes Some Advantage plans include part D rx coverage, but not all

Overall Flexibility

Yes  Allows insured to change plans and disenroll anytime; no network limitations

No - Insured must wait until certain times of the year to disenroll; can be difficult to re-enroll in a Medicare supplement

Comparing Medicare Rates, Out-Of-Pocket and Flexibility

It is difficult to balance monthly insurance premiums versus potential out of pocket expenses between the two. If you remain in good health, an Advantage plan will be the less expensive choice over time.  However, if you have regular health issues or a significant incident, an Advantage plan can have much higher out-of-pocket expenses.

Furthermore, you simply may not be able to switch back to a traditional supplement if you have certain preexisting conditions.  Most Medicare supplement providers require medical underwriting if you have been enrolled in an Advantage plan for over one or two years.  In other words, you can be declined coverage.  Additionally, it can be difficult to disenroll from a MA plan if it is not the correct time of year.

In fairness, there are states like Florida where Medigap rates are higher than most other places due primarily to the demographics.  And regardless of out-of-pocket expenses, some consumers simply cannot afford both a supplement and a Part D plan.  For these folks, an Advantage plan can be the most suitable option.

Medicare Advantage Networks Doctors and Hospitals

One important difference between supplements and MA coverage are the network options.  Unlike almost all supplements, MA plans have a network of doctors, hospitals and medical facilities that the insured is mostly required to use for service.

The problem arises when a specialist is needed for consult or if the insured is admitted to a rehabilitation or other medical facility that is out of the provider network.  It's not that the insured cannot see these professionals or use the facility, but the Advantage plan may provide little in the way of reimbursement if any at all.  This can lead to significant out-of-pocket expenses.

Prescription Drug Part D Rx Coverage

This is an area where MA plans tend to be more beneficial to the insured.  Current laws allow insurance companies to package Advantage plans and Part D coverage together in one package.  Not all MA plans combine Parts C and D together, but many do as an incentive to the consumer.

Conversely, Medicare supplements and prescription Part D coverage must be sold separately by law.  There was a time when the two plans could be purchased in tandem, but recent regulations separated the two.  Many companies offer both supplemental and Part D, however they cannot be purchased together.

This means that Part D plans will come at an additional cost for those who want a traditional Medicare supplement.  Part D rates vary widely and most consumers purchase coverage based on their current prescriptions.  Typical rates can range from $12 to $100 per month and in most cases suitable coverage can be found for around $25 monthly for the majority of consumers.

What Does The Future Hold For Advantage Plans?

It's hard to say.  Health care reform is an evolving piece of some of the most significant legislation passed in recent decades.  Medicare supplements are here to stay, but Advantage plans might go the way of the dinosaur extinct.

In some states, this is happening already.  In Tennessee, for example, Anthem Blue Cross Blue Shield discontinued all MA plans as of January 1, 2011.  This caught members by surprise and several were scrambling to find replacement coverage.

It is important to note that if your MA provider leaves your service area or discontinues coverage, you will receive an open enrollment window where you can purchase some supplements (or new MA plan if one exists) without any required medical underwriting.

Contact Us For Quotes And Coverage

In summary, there is not a one-size-fits-all plan for Medicare beneficiaries.  You can only base your decision to purchase Part C coverage on what you can best afford now and in the future while also factoring in potential out of pocket expenses.

Compare Medicare Supplement Insurance