After enrolling in Medicare, you still need to decide how you want to receive your benefits and whether or not you need extra coverage beyond Part A and Part B. The good news is, you have choices. You can stay with Original Medicare and join a Medicare Supplement Insurance Plan for help with out-of-pocket expenses. Or, you can join a Medicare Advantage plan and receive all of your Part A and Part B plus extra benefits through one complete plan. Medicare Supplement plans cannot be combined with Medicare Advantage. Taking some time to understand the differences between the two will help you make an informed decision about your health care.

Medicare Supplement

Medicare Supplement, sometimes called “Medigap”, is offered through private insurance companies to “supplement” Medicare. A Medigap plan can help you pay for costs not covered by Original Medicare, like deductibles, copayments, and coinsurance. There are no networks and you are free to use any doctor or healthcare provider you choose who accepts Medicare.

Plans are standardized. Plans are identified by letters of the alphabet and are standardized by the federal government. That means a Plan A in one state must offer the same minimum benefits as a Plan A in another state. However, they don’t have to charge the same—and they don’t.

Cost varies between plans. You must have Part A and B to be eligible to join a plan. In addition to a monthly premium, you will be responsible for paying your Part B premium.

Plans do not offer prescription drug coverage. If you need drug benefits, you must enroll in a stand-alone prescription drug plan offered through Medicare. 

Help with costs. Deductibles, premiums, and copayments can be costly, and the right Medigap plan can shoulder many of these out-of-pocket costs.

Medicare Advantage

Medicare Advantage, also called Part C, is offered through private insurance companies approved by Medicare. When you join an MA plan, you still have Medicare, but receive your Part A and Part B benefits through your Part C plan.

Additional benefits beyond Original Medicare. Medicare Advantage provides additional benefits beyond Original Medicare. While each plan is different, most include prescription drug coverage, and many include benefits for dental and vision care.

An all-in-one solution. Part C coverage is a comprehensive Medicare solution, providing all of your traditional benefits, plus extras in one complete plan.

Each plan is different. Different MA plans have different rules for how you receive your benefits. With some plans, you must use doctors and hospitals within the plan’s network and may need to get a referral to see a specialist.

Cost varies between plans. Comparing plans is the only way to find the perfect combination of cost and benefits. With an MA plan, you will still need to pay your Part B premium, although many plans offer low or zero monthly premiums.  

Important to Remember 

Both Medicare Supplement and Medicare Advantage can help you secure the benefits you need and deserve. Remember, Medicare Supplement insurance helps with out-of-pocket expenses but does not typically provide coverage for services beyond Original Medicare. If you need dentures or a new pair of eyeglasses, your Medigap plan will not help. Medicare Advantage does provide additional benefits beyond Part A and Part B, but cannot be combined with Medicare Supplement.

MUC44-2017-BCBS

References:

Medicare Advantage: https://www.medicare.gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/how-medicare-advantage-plans-work.html

Medicare Supplement: https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html

Extra: https://www.medicare.gov/supplement-other-insurance/medigap/medigap-and-medicare-advantage/medigap-and-medicare-advantage-plans.html