Medicare Advantage Plans vs. Medicare Supplemental Insurance Plans

Senior citizens who are eligible for Medicare are faced with choosing a Medicare plan that best suits their needs. However, this can be very confusing since there are several options available. Basic Medicare is not enough insurance to cover most individuals. Therefore, there are two options available in which seniors must choose from to supplement their Basic Medicare. The two plans are Medicare supplemental insurance plans and Medicare Advantage plans. It is very important to know the difference between these two plans in order to determine which plan is best as they are easily confused with each other.

Medicare supplements are insurance policies that can be purchased by seniors to cover the gaps left by Medicare. This insurance is often referred to as Gap Insurance. The gaps that are left include, coinsurance, deductibles, copays, laboratory expenses, surgeries, hospital stays, as well as other unforeseen medical expenses. There are dozens of Medicare Supplements out there to choose from, and they all cover the same type of services. Even though all Medicare supplement insurance companies provide coverage for the same service, they don’t all provide the same amount of coverage. Therefore, you need to take into consideration where you stand as far as your health to determine which plan is the best financial choice. Plans can get pricey depending on the amount of coverage. It may be cheaper for someone who rarely goes to a doctor to choose a plan with more out of pocket expense rather than paying higher premiums. All doctors and medical facilities that accept Medicare Insurance accept Medicare Supplement insurance. The average premium for Medicare Supplements is $150 per month.

Medicare Advantage Plans are issued by private insurance companies that receive subsidy from Medicare Insurance. Medicare pays the private insurance company a premium to cover the individual. Medicare is essentially selling your insurance to the private insurance company. Your Medicare Advantage Plan is then liable to pay all of your covered benefits. All Medicare Advantage Plans are required to provide the same coverage as Medicare-covered benefits. Medical Advantage Plans include Health Maintenance Organizations (HMOs), Private Fee-for-Service Plan (PFFS) and Preferred Provider Organization (PPOs). Since these plans are private owned companies they have their own network of doctors and facilities. If you choose to use a provider out of network you may have to pay out of pocket costs. These cost are usually deductibles, co-pays and unreasonable charges incurred by non-participating doctors and facilities. Therefore, it is wise to find and establish doctors within your network. The biggest advantage to choosing a Medicare Advantage Plan is that the average premium is approximately $50 per month and sometimes free. The disadvantage is not every Medicare provider accepts these plans.