Medicare Part A and Part B cover many different healthcare expenses. But, it does not cover everything. Along with these covered health services, recipients often are responsible for a variety of copayments and deductibles. Routine vision and dental visits, prescription drugs, are also not covered by Medicare A and B. With just Original Medicare, you will have to pay for these services out of pocket.
There are two options to “fill in” these gaps in coverage, Medicare Advantage and Medicare Supplement (Medigap). These options differ greatly from one another. Its very important for you to understand the differences as you prepare to enroll in Medicare benefits.
Medicare Advantage vs. Supplement Insurance
Medicare Supplement insurance plans work along with Original Medicare. It is best to think of Medicare Supplement Insurance as an extension for Original Medicare (Part A and Part B). Medicare pays for your healthcare bills primarily, while the Supplement plan covers certain cost-sharing expenses required by Medicare, such as copayments or deductibles. As well as other expenses such as Medicare Part B excess charges.
Medicare Advantage plans are best thought of as an alternative to Original Medicare. If you choose to go with a Medicare Advantage plan you will be getting your Medicare benefits through a Medicare-approved private company. The Medicare Advantage plan replaces your Original Medicare coverage. It is important to note, Medicare Advantage plans must provide the same level of coverage as Original Medicare, with the exception of hospice care.
Finding Medicare Providers
Medicare Supplement plans are accepted by any medical provider that accepts Medicare. On the other hand, Medicare Advantage plans can have more restricted networks. This means that with some Medicare Advantage plans you may only use doctors and hospitals that are contracted with your specific plan. Other Medicare Advantage plans may allow you to use a preferred provider that is out of network, however, you may pay higher copayments and coinsurance.
To get the best Medicare coverage, it is best to really understand your needs. Every person’s situation is different and what is best for you might not be what is right for your neighbor. It is important to consider both Medicare Advantage plans and Medicare supplement to find the best option that fits your needs.
Want to learn more? Click here to listen to our Medicare Made Easy Podcast Episode 2 where Rob and Lisa discuss the difference between Medicare Advantage Plans and supplement plans.