Wednesday, January 28, 2015

Do you know the difference between Medicare Supplements and Medicare Advantage Plans?

There are some very important differences.

When it comes to Medicare, you have a number of options including Original Medicare, Medicare Supplements and Medicare Advantage Plans. Here’s a short explanation of each of these:

Original Medicare is the federal insurance program for people age 65 or older, certain younger people with disabilities and people with End-Stage Renal Disease. While Original Medicare will cover a big part of your medical bills, it does not cover 100% of them. Your out-of-pocket costs will include deductibles, coinsurance and copays in addition to your premiums. These costs can add up quickly if you have a serious illness or medical condition.

Medicare Supplement Insurance (sometimes referred to as Medigap Insurance) is insurance coverage sold by private companies that you add to Original Medicare Part A & B. The purpose of a Medicare Supplement is to help pay the out-of-pocket costs not covered by Original Medicare.

A Medicare Advantage Plan is a government-approved alternative to Original Medicare. Advantage Plans are offered by private companies that contract with Medicare to provide all Part A & B benefits, plus additional benefits and services. With an Advantage Plan you will pay Part B premium plus the Advantage Plan premiums, often as low as $0. Prescription drug coverage may be included. With an Advantage Plan, your out-of-pocket costs will include copays, deductible and coinsurance. 

One of the most important benefits of Advantage Plans is that annual out-of-pocket costs are capped. Once you reach a pre-set limit, your plan will cover 100% of your hospital costs for the remainder of the year. There is no annual cap with Original Medicare.

There are a number of other issues to take into account before you decide which is right for you, including whether you travel out of the state or country, your prescription drug regimen and whether you need additional coverage for vision or dental care. Please contact me at 440-255-5700 or to go over your specific situation.

1 comment:

  1. The most important benefit of an advantage plan is really quite a selling point. I think that I might need to understand the amount that the out of pocket money is capped. However when 100% of medical costs are covered after pocket costs are capped seems like a great way to go.