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LEARN ABOUT Medicare Supplements VS Medicare Advantage Plans
There are 12 Federally approved Medicare supplement plans-A through N.
Medicare Supplement plans are often called a Medigap insurance that are federally approved plans labeled A-N. These plans are established by the Federal Government and follow the the guidelines and benefits are the same, but the premiums vary depending on the insurance company that offers them.
Medicare Advantage plans are relatively new. Private insurance companies have to meet minimum requirements set by the federal government. Insurance premiums varies in price, coverage, network size, network quality, speed at which payments are processed and approved, and many other variables. Most function similarly to an HMO, with in-network and out-of-network services, yearly out-of-pocket maximums and are generally not suited to individuals that travel frequently.
Below is a quick comparison of the Medicare Supplement and Medicare Advantage Plans for your review until your free booklet arrives.
Medicare Supplement (pay now - save later)
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Medicare Advantage (save now - pay later)
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| Part A Medicare (Plans A - N)
- Hospital deductibles
- First 60 Days - Medicare pays all but $1,068 (paid depending on plan)
- Skilled Nursing
- First 20 days paid by Medicare.
- 21-100 days Medicare pays all but ($133.50 paid by you or may be paid by plan depending on plan).
- 101+ days Medicare pays zero (plan don't cover).
- Deductibles are oftentimes covered by plan.
- Deductibles
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Part A
- Private Company manages insurance costs - not Medicare.
- Company is in 1st position.
- Zero/low monthly premium.
- Hospital deductibles.
- Coverage is determined by private company.
- Most commonly they are HMO type plans with separate in-network and out-of-network costs.
- Hospital co-pays/coinsurance.
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| Part B Medicare
- Part B - minimum $96.40 - $353.60/mo.
- Any doctor that accepts medicare.
- Part B excess charges (paid depending on plan).
- In-patient and out-patient medical/surgery.
- $155 annual deductible (paid depending on plan).
- Durable medical equipment supplies (paid depending on plans).
- Therapy - physical and speech.
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Part B
- Part B - minimum $96.40 - $353.60/mo.
- Network of hospital and doctors.
- Out of network - higher co-pays/coinsurance/or no coverage.
- Emergency services
- Out of pocket expenses - separate for in-network/out-of-network.
- Co-pays.
- Deductibles.
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| Freedom of Choice
- Any doctor.
- Any hospital.
- Low monthly premium.
- No deductibles for certain plans.
- No RX coverage (part D stand-alone plan needed).
- No co-pays or co-insurance to see doctors or other treatments depending on plan.
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Limited to Network
- Zero/low monthly premium
- Network of doctors and hospitals
- Deductibles and co-pays
- Yearly out-of-pocket expenses for both in-network and out-of-network services
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| Medicare Supplement Highlights
- ICD codes billed with Medicare set up topay fast.
- ICD codes billed with Medicare set up to pay.
- Medicare approved pays 80%.
- Medicare approved: Medicare pays 80% Supplement pay 20% = 100% bill paid.Each plan is regulated by the government and has the same benefits (example- every Plan G is the same no matter what company offers it), only the premiums can change.
- Each plan is regulated by the government and has the same benefits (example- every Plan G is the same no matter what company offers it), only the premiums can change.
- Depending on the plan it may result in no out of pocket treatment costs.
- "Pay now - Save Later" means higher monthly premiums but little or no out-of-pocket for treatment.
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Medicare Advantage Benefits
- Zero/Low monthly premium.
- RX coverage may be included with co-pays.
- May include:
- Eye exams
- Dental cleanings
- Hearing aids/discounts
- Discounts for health facilities.
- No health qualifying to change Medicare Advantage Plans during open enrollment.
- Deductibles and Out of Pocket maximums are determined by plan (usually $2,500-$10,000 per year).
- "Save Now - Pay Later" means lower monthly premiums but much higher yearly out-of-pocket expenses may be incurred.
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Get a FREE, confidential consultation and learn about all your Medicare options with a licensed agent ($250 value).
* Not affiliated with Medicare, Medicaid, or any specific insurance company. Information provided for educational purposes only. An in home visit including a signed application with a licensed agent is required to create any insurance policy.
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