Original Medicare parts A and B cover most health-care expenses for those enrolled, but it won’t cover everything. Medicare beneficiaries are still required to pay a number of deductibles and copays, which can start to really add up over time. Part A and B also don’t cover things like dental, vision, prescription drug coverage, or travel insurance.
Having Original Medicare is great, but you’ll still have a lot of out-of-pocket expenses.
For this reason, many folks opt to enroll in 2 additional plans to reduce or eliminate these out-of-pocket costs. These are known as Medicare Advantage plans and Medicare Supplemental (Medigap) insurance plans. They work in conjunction with Original Medicare and both help with costs that aren’t covered by Original Medicare. But there are some key differences between these two varieties of Medicare supplemental insurance which you should be aware of before enrolling.
Let’s take a look.
Medicare Supplemental (Medigap) Insurance Plans
A Medicare Supplemental insurance plan works along with Original Medicare part A ad B and helps cover some costs that Original Medicare won’t. They are not their own plans, instead, they work with Original Medicare. You cannot enroll in a Medigap plan without first being enrolled in Original Medicare.
Medigap covers specific cost-sharing expenses like deductibles and copays. A Medigap plan can also help with costs not fully covered by Part B like emergency care when traveling abroad or additional charges. Medicare Supplement (Medigap) insurance only covers costs from Original Medicare and cannot be used with a Medicare Advantage plan.
Benefits of Medicare Supplement Insurance
Medigap plans cover many costs that are not covered by Original Medicare like coinsurance, deductibles, and copayments. Some supplemental plans will cover things that Original Medicare won’t like emergency medical care when you are traveling abroad or some pints of blood when you need bloodwork.
Disadvantages of Medicare Supplement Insurance
A Medigap or Medicare Supplement plan will not cover prescription drug costs. Medigap also doesn’t typically cover routine things like dental, vision, and hearing coverage beyond Original Medicare coverage.
Benefits of a Medicare Advantage Plan
While a Medigap plan supplements some costs associated with an Original Medicare plan, a Medicare Advantage plan is used as an alternative or replacement to Original Medicare. The real difference is who administers Medicare insurance. You’re still enrolled in Medicare, but with Original Medicare, the service is run by the federal governments’ program while with a Medicare Advantage plan the service is run through a private insurance company.
Medicare Advantage plans require the same level of health care coverage as federally run Original Medicare. However, as they are run by private health insurance companies there can be some differences compared to Original Medicare.
Disadvantages of Medicare Advantage Plans
Medicare Advantage plans are offered by private companies and must cover what Original Medicare does. However, not all providers have the same coverage levels within their Advantage plans. So, one drawback of Medicare Advantage plans is that they can vary substantially from one insurer to the next. This means there are no standardized benefits across different providers. You are also usually required to pay coinsurance and copays.
Where to find Medicare Providers
During the Medicare open enrollment period, there are lots of different ways to go about getting a Medicare insurance plan. You should first do some research as to the variety of plan you’re looking for and if you need to supplement its level of coverage in any way. Keep in mind that some Medicare Advantage plans will offer coverage from providers within a specific network. So, you should look at your doctors and see what sort of Medicare providers they work with.
