If you’ve just finished enrolling in a Medicare program, the next thing you have to do is decide how you would want to receive Original Medicare (Part A and B) benefits and whether or not you need an additional coverage. Basically, you’ll be deciding is a Medicare Advantage plan is the right choice or if you just have to stick with your original Medicare coverage and for added benefits, just get a Medicare Supplement plan. Whichever you choose, each of these options has its own benefits, rules, and costs that you need to weigh prior to making a decision. To guide you better, here are the things you need to know about these two.
Medicare Advantage Benefits
It is common for private insurance companies to be more flexible with their Medicare Advantage plans. Therefore, it’s not surprising to see differences between plans. So you need to be careful when comparing the plan options so you won’t overlook anything.
Since Medicare Advantage plans have benefits beyond the Original Medicare, the coverage may include the following: health and wellness programs, routine dental, vision, and hearing. If you are under the Original Medicare, you’d normally pay for these services.
Medicare Supplement Benefits
There are Medigap plans available in the majority of states. Each of them is uniquely designed by a different letter (e.g. A). The coverage is also standardized which means that you can get the same benefits for Medicare Supplement coverage regardless of the company where you purchased it from. But, even if the benefits are the same, the premium cost may still vary depending on the insurance company and its location.
In Medigap plans, the Original Medicare does not cover out-of-pocket costs such as coinsurance, copayments, and deductibles. It also does not include prescription drug benefits. But there are some plans that can help pay for some benefits that are not covered by Original Medicare like emergency health coverage outside of the country. Moreover, Medicare Supplement plans generally do not offer extra benefits such as routine dental, vision, or hearing coverage beyond what is already covered by Medicare.
Finding Medicare Providers
Medicare Supplement plans are accepted by any medical provider that accepts Medicare. In contrast, Medicare Advantage plans may have more restricted networks, depending on the plan. For instance, some Medicare Advantage plans, such as Health Maintenance Organization (HMO) plans, use a provider network that you must use to be covered. This means that you can only see doctors and hospitals that are contracted with your Medicare Advantage plan and part of its provider network. Other plans may use a preferred provider network that lets you see both in-network and out-of-network providers; however, you may pay higher copayments and coinsurance when using non-network providers.
Every person’s situation is different, and it’s important to consider both your Medigap and Medicare Advantage plan options to find the coverage that fits your needs. Doing so will allow you to make the most of the benefits provided.