Medicare Advantage vs. Medicare Supplement Plans

Coke or Pepsi? Domino's or Pizza Hut? Miller Lite or Bud Light? Burger King or McDonalds, Popeye's KFC or Chik-Fil-A? Everyone has their own preference when it comes to what tastes the best to them. And, Medicare Insurance is no different. Aside from the question "Why Is Medicare Not Free", the next most asked question by our clients is "Which Is Better, Medicare Advantage or Medigap/Medicare Supplement plans"?

In all fairness, I believe 100% of Independent Medicare Brokers will tell you that Medicare Supplements paired with Original Medicare offers superior coverage, flexibility and predictability than any Medicare Advantage plan available. This is because there are better benefits, better access to quality healthcare and over your lifetime, the combination of Original/Traditional Medicare with a Medicare Supplement Plan N, G or F will have the lowest exposure to financial risk that you could have. But, everyone with Medicare has a choice, and it is important to do your best to make the most out of your decision.

A lot of things come into play, the first is Healthcare is Personal. And, as such, everyone has a different view or take on what is most important to them, and their families when it comes to healthcare. Do you travel? Do you like being in control of your Healthcare? Do you like having to see a Primary Care Provider, Do you mind needing to get referrals to see a specialist? How large is your rainy Day Fund? What plans are available in your area? Do your wear glasses or contacts? Have you had any Health Scares? Do you take Prescription Medications, etc.

Another key but inexact thing to do is not to think about your health and your healthcare needs at 65, because you will only be 65 for a year. you need to try and project what you think your life and more importantly your health will look like over the next, 5, 10 and 20 years. I know that is difficult, but look back and reflect on your older family members, remember when they were 65 and then at 75 or 80? Eventually life and Father Time come into play, and eventually we all realize that we are no longer in our 40's or 50's and we are not bullet-proof any longer. I know it is a difficult thing to predict, but you are not looking going to be able to fully compare your needs unless you can complete this exercise to the best of your ability.

In this brief article we will touch on the biggest differences between Medicare Advantage Plans and Medigap Plans. For more detailed information you can find much more information an all things Medicare on our website at www.bradenmedicare.com and on the www.medicare.gov website.

How To Compare Medicare Advantage vs. Medigap Plans

If you are new to Medicare or want to change your plans, finding the plan with the right health benefits for you is essential. When deciding which plan to enroll in, your first step should be to choose between Medigap plan vs. Medicare Advantage plans. Understanding which plan type best fits your needs is top priority when enrolling in coverage. And, remember, you only have one chance to enroll in any Medicare Supplement Plan that you desire during your one-time, Initial Enrollment Period (IEP).

Many people think they can get by on the cheap for a few years, but if you run into a big health situation or health scare, you may not qualify for a Medicare Supplement or Medigap plan down the road, due to the fact you will have to pass the Medical Underwriting process. We have seen to many bad things happen to good people, so please just do your homework and put a lot of thought into your decisions. If you do that, then whatever you decide to choose (Medicare Advantage or Medicare Supplement/Medigap), you will be choosing what you believe is the best plan for your.

There are many differences between Medicare Advantage vs. Medicare Supplement plans. So, it is crucial to research and thoroughly understand how each plan type works before deciding. You are not alone in your research, and we are here to help you every step of the way if you need us.

Note: Think of your children and your spouse when making your decision, and involve them as much as you can. Why? The answer to that is simple, because eventually, whether you like it or not or want to think about it or deny it, there is a high percentage that they will be the ones who are in charge of your healthcare on down the road. And, you may not believe this, but spouses and children and grandchildren, always want the best coverage and the best care for their parents and grandparents, more than most people want for themselves.

The Major Differences Between Medicare Advantage Plans and Medigap (Medicare Supplement) Plans

While Medicare Supplement plans pay secondary to Original Medicare, Medicare Advantage plans become your primary source of coverage when you enroll. Did you know that Medicare (The US Government) Medicare pays about $1,000 per month to the Medicare Advantage Insurance Companies, simply for taking on the risk of your healthcare? The idea is that this pays for your healthcare needs. In reality, this is where the majority of all Medicare Advantage plans get the money to advertise like crazy, and; how they can offer additional benefits that are not allowed under Original Medicare.

When Medicare was started, the idea was simply for older Americans to be able to have access to hospitalization and healthcare in retirement. Eventually, Insurance companies lobbied the House of Representatives and the US Senate to be able to offer "alternatives" to Original Medicare. This was when President Clinton signed Medicare Part C (C stood for Choice back then) into Law, Then, later president George W Bush signed Medicare Part D into law.

Much like your taste in food and beverages we mentioned at the start of this article, depending on your lifestyle, budget, and medical coverage needs, one typ of Medicare plan will suit your needs more than the other.

The Pros & Cons of Medicare Advantage and Medigap/Medicare Supplement Plans

There are several differences between Medigap vs. Medicare Advantage plans. A Medicare Advantage plan (Medicare Part C) is structured as an all-in-one option with low monthly premiums.

Medicare Supplement plans offer additional coverage to Original Medicare with low to no out-of-pocket costs. The chart below reviews the pros and cons of Medicare Advantage and Medicare Supplement plans.

When it comes to Medicare Advantage vs. Medicare Supplements, the biggest complaint we hear from our clients is that they are unable to accurately predict their out-of-pocket costs when enrolled in a Medicare Advantage plan. They are also shocked that there are so many hoops to jump through and many times they have been stalled by needing to get 2-4 second opinions, before receiving treatment for their condition. They find out the hard way, that having a Medicare Advantage Plan is like the Man Behind The Curtain in the Wizard of OZ, because your insurance company sadly has the final say on your coverage and your treatment, you don't and sadly, neither does your doctor.

On the other hand, the biggest compliment we hear from clients is regarding Medicare Supplement plans. Most beneficiaries stick with Medicare Supplement plans because of their ease and reliability. The option to go to any doctor that accepts Original Medicare is the cherry on top of Medicare Supplement plans.

Which Plan Is Better in the End, a Medicare Advantage Plan or a Medigap Plan (Medicare Supplement)?

Medicare does not offer a one-size-fits-all plan. So, the best policy for you is the policy that best meets your healthcare needs.

Medicare Supplement plans are the best option if you want complete reassurance and predictability with your healthcare but are comfortable paying higher premiums in exchange for lower out-of-pocket costs.

In contrast, Medicare Advantage plans are the best option if you hope to save on monthly premiums and receive additional benefits while accepting responsibility for additional out-of-pocket costs at the doctor’s office.

For overall ease and reliability, our recommendation is always Medicare Supplement plans. However, we know that may not work for everyone. Our goal is to provide you with your best options regardless of plan type.

Wrapping Things Up

Do you want predictable costs, the freedom to choose any doctor, avoid referrals, and peace of mind while traveling? If you answered yes, you are looking for a Medicare Supplement plan.

Are you comfortable with unpredictable copayments, strict doctor networks, and referrals in exchange for a lower monthly premium and additional benefits? If your answer is yes, Medicare Advantage could work for you.

The best part about working with agents is that no matter which option you choose, we make sure it is the best for you.

Perhaps you are already thinking about making the switch from a Medicare Advantage to a Medicare Supplement plan, or the other way around. If you need help, or perhaps would like more information than we have provided in this article, please feel free to contact me directly at mike@bradenmedicare.com.