Medicare Advantage vs Medicare Supplement Plans (Updated Review and Important Tips)

This is one of the most frequently asked questions, if not the most common, that I receive, so today I'm going to do a simple and up-to-date explanation of the difference between Medicare Supplement

plans

and Medicare Advantage

plans

, so stay tuned. Hello everyone, I'm Stephanie. Medicare licensed insurance broker and welcome to my channel, this is where I answer my most frequently asked questions about Medicare and offer educational videos about Medicare so we can help you simplify the confusing world of Medicare. My team and I are licensed in almost every state, so we help seniors across the country with their Medicare insurance and one of the most common confusions I see is that people don't always understand the difference between

supplement

al plans.

Medicare and Medicare Advantage plans. There are also many advertisements you will see on television that do this. Even more confusing for people and there are some videos that talk a little bit about the difference between these two options, but today I really wanted to do an update video on this topic, so that's what we'll dive into traditional Medicare has two. main parts

medicare

part a and

medicare

part b part a is your hospital insurance and for most people it is free medicare part b is your health insurance and for most people you must pay for it, standard part b premium in 2021 It is 148 and 50 cents per month, it may be higher if you are high income and that part b premium may increase over time and once you are enrolled or enrolled in Medicare parts a and b you basically have two options

tips

on how to receive it. your Medicare benefits it is like there is a fork in the road you choose one path or another and that is how you will receive your coverage so I would like to use a little flow chart to explain this and it is

important

to know that no matter what Whichever way you choose, you will generally still have to pay the Medicare Part B premium, that $148.50 per month premium, you will still have to pay no matter which way you choose.

The first path is where you keep traditional Medicare parts a and b as your primary insurance. coverage and this means you can maintain the freedom to visit any Medicare doctor anywhere in the country and most medically necessary services will be covered under parts a and b. Your doctor, your hospital will bill Medicare as your primary insurance and from here you will likely add a stand-alone Medicare Part D prescription drug plan to cover your prescriptions. Additionally, many people like to add a Medicare Supplement or Medigap plan to cover all the deductibles, coinsurance, and out-of-pocket costs that traditional Medicare Parts A and B don't pay for.

Many insurance companies offer Medicare Supplement plans, but the benefits are standardized, so if you choose, say, a Medicare Supplement g plan with one company, that is exactly the same plan as if you purchased it. through any other company, so what's so good about Medicare Supplement plans? What is good about this path? First of all, there are no doctor networks you need to worry about, so you can always visit any Medicare provider wherever you are, wherever you live, wherever you travel, you can choose. your own doctors, Secondly, on this path, you have the peace of mind of knowing that you will not actually have to pay large medical bills because your Medicare Supplement plan will cover almost all or all of your potential out-of-pocket costs under the parts. a and b, these plans give you very comprehensive coverage, so you generally have little to no deductible and co-pays.

So what is the downside of this path? Well, Medicare Supplement plans have an additional monthly premium that you have to pay on top of the share. The b premium you are already paying in most of the country. Medicare

supplement

insurance for a 65 year old will range from 80 per month to 150 per month, but that depends on where you live. Additionally, these plans do not include dental or vision benefits. Therefore, Medicare Supplement plans are designed to cover all services that traditional Medicare Parts A and B cover, and since traditional Medicare Parts A and B generally do not cover dental and vision services, then your Medicare Supplement plan Medicare wouldn't normally cover it either now, let's talk about the other option, the other path you can take, which is Medicare Advantage.

Medicare Advantage plans are also known as Medicare Part C, but they are actually plans that are alternatives to your traditional Medicare benefits, so private insurance companies contract with Medicare to offer these Medicare managed care. Advantage plans and Medicare Advantage plans cover all services covered by traditional Medicare parts a and b and generally include part D prescription drug benefits built directly into the plan when you enroll in a Medicare Advantage plan, such as an HMO or PPO plan. They are choosing to receive their benefits through this insurance company's managed care plan, so when you go to the doctor or the hospital, they no longer bill traditional Medicare, they bill your Medicare Advantage plan.

The insurance company. Medicare Advantage plans can set their own cost sharing. Your own co-pays and your own deductibles for your medical and hospital services. Plus, these plans often include some coverage for things that aren't covered by traditional Medicare, like dental, vision, or hearing services. Keep in mind, as I said before, that in most cases you should continue. pay your part b premium even if you enroll in a Medicare Advantage plan. So what's so good about Medicare Advantage plans? Well, these plans are usually very affordable in most parts of the country. Medicare Advantage plans start at zero dollars per month, so they can be a truly great alternative for people who can't afford a Medicare Supplement plan.

Plus, these plans include your medical coverage, your prescription drug coverage, and sometimes your dental and vision coverage all in one plan so you have a card to carry with you in your wallet and a Many people like that convenience, so what are the dis

advantage

s of these plans? Well, these plans use provider networks that can change over time, so you don't have as much freedom of providers, you're usually more limited to an established network of doctors and hospitals. Some plans offer out-of-network coverage, but generally have much higher cost sharing for you. Additionally, Medicare Advantage plans have out-of-pocket maximums that are set to help limit your out-of-pocket expenses in the event of a catastrophic medical event, but many Medicare Advantage plans have out-of-pocket maximum limits that are on the high end in 2021. , the standard Medicare Advantage maximum out-of-pocket limit is seven thousand five hundred fifty dollars per year, so if you had a major medical event, illness, etc., you may be responsible for paying up to that out-of-pocket limit each calendar year.

Additionally, these plans may require referrals to see a specialist or prior authorizations for certain medical services, while traditional Medicare has rarely required prior authorization. authorizations for medical services, so there are many different factors to consider when debating Medicare Supplement plans versus Medicare Advantage plans. Your budget. Your medical history, as well as the types of plans and prices available in your area, are just a few of the things you'll want to keep in mind, and of course, this is exactly what we help people do every day as a broker. independent. Our service is free and because we work with both Medicare Advantage plans and Medicare Supplement plans, we can offer you.

An unbiased

review

of plans in your area to help you determine what type of coverage will best meet your needs. Something that's

important

to remember is that in most states, Medicare Supplement plans are generally medically underwritten when you're not new to Medicare, in other words. When you're new to Medicare, you have this one-time open enrollment window where you can purchase any Medicare Supplement plan you want without any medical underwriting and you're given the preferred rate, but after that window closes, you'll typically have to go through by medical underwriting to even qualify for a Medicare Supplement plan in the future, Medicare Advantage plans, on the other hand, are not medically insured and typically any Medicare beneficiary can enroll in a Medicare Advantage plan each fall during the annual election period, so many people assume they can simply switch or switch from Medicare Advantage to Medicare Supplements from year to year, but that's not necessarily the case.

It will depend on your health whether you want to switch from a Medicare Advantage plan to a Medicare Supplement plan. In most situations, an easy way to find out your eligibility for plans and pricing in your area is to go ahead and call us. You can send me an email and my team and I will be happy to help you. Thank you so much. By watching, if you find value in this video, I will ask you to click the like button. You can subscribe to the channel if you haven't already and definitely leave me all your questions and comments below, thank you. again thank you very much for being here and see you soon