Medicare Advantage vs. Medicare Supplements
- ORIGINAL MEDICARE (works in tandem with a Medicare Supplement)
- MEDICARE ADVANTAGE- Part C (all in in one plan)
ORIGINAL MEDICARE, comprised of:
- Medicare Part A (Hospitalization)
- Medicare Part B (Doctor’s expenses)
- Medicare Part D (Prescription Drug coverage)
Original Medicare does not pay all costs of your health care! There are deductibles and co-payments. Medicare Supplements complement Medicare and will help fill the gaps. Health care providers bill Medicare directly and Medicare will turn around and send the balance of the bill to the Medicare Supplement company.
As long as you assign benefits to your provider, the Medicare Supplement company will pay your provider directly. Normally, you do not have any claim forms to fill out. The claims process is seamless. Each year, Medicare’s deductible and copays increase and Medicare Supplements automatically adjust to cover that increase. Please see the chart on the Medicare Supplements page to see exactly how Medicare and a Medicare Supplement work together to pay your medical bills.
Medicare Supplements do not pay for prescription drugs. This is where Medicare Part D comes in. Medicare Part D plans are sponsored by private insurance companies with a Medicare contract. For more information, please visit the Medicare Part D page.
MEDICARE ADVANTAGE (Medicare Part C)
Medicare Part C takes the place of original Medicare Part A, Part B, and usually Part D. Thus, Medicare Advantage plans are usually referred to as an “all in one plan”.
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DIFFERENCES BETWEEN A MEDICARE SUPPLEMENT AND MEDICARE ADVANTAGE PLAN |
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| Purpose: | Supplements Medicare’s gaps | Takes the place of Medicare |
| Access to doctors: | You can see any Medicare-approved doctor or specialist without a referral. | You normally must stay within a network. |
| Access to care: | Nationwide. Emergency care benefits available if out of the country. | Must stay within a network. Some networks are regional, some are national. No coverage for emergency care out of country. |
| How many plans available: | Limited to 10 Standardized plans nationally. | Plans are available on a state, regional or county basis. |
| Deductibles, Co-pays, Co-insurance | Submit to terms of each specific plan. | Submit to terms of each specific plan. |
| Prescription Drug Coverage | Not Covered. You must purchase a separate Part D PDP. | Usually includes prescription drugs. Part D is usually not necessary. |
| Renewability: | Guaranteed Renewable (unless you stop paying your premium). | Benefits may change yearly. Plans may also exit an area. |
| Availability: | You can apply at any time. With certain exceptions, there are health questions. | You may only apply during certain Open Enrollment periods. |
| Value Added Benefits: | None | Some plans cover extras like limited dental, vision, hearing, meals after hospitalization, transport to doctor’s visits. Some plans include health club memberships and may help pay your Medicare Part B premium. |
Questions or would like further information? Please feel free to call me at (910) 775-0700 for a FREE consultation!