Medicare Supplement vs Medicare Advantage, Which One Is Right for You?
You are turning 65 and ready to enroll in Medicare. You may ask this question: What can I expect my Medicare costs to be?
Your basic costs look like this: Deductibles — Medicare Part A will cost $1,600 per benefit period. Medicare Part B will cost $226 per year. Premiums — There is no Part A premium, and the 2023 Part B premium is $164.90. Coinsurance — Your Part A coinsurance is $0 coinsurance for the first 60 days of each benefit period, $400 a day for the 61st to 90th days of each benefit period, $800 a day for days 91 and beyond per each lifetime reserve day of each benefit period (you get up to 60 lifetime reserve days). With Part B, once your deductible is paid you’ll be responsible for 20% of doctor’s costs,including hospital stays.
Two popular health insurance options are available to help manage your healthcare costs: Medicare Supplement and Medicare Advantage.
What is a Medicare Supplement?
Between coinsurance, copays, and deductibles, costs can add up quickly, even with Original Medicare coverage. That’s where a Medicare Supplement plan comes in. Also known as Medigap, this private health insurance policy takes care of everything that isn’t covered by Medicare Parts A and B. Close the gaps in your coverage with a Medicare Supplement plan.
What is a Medicare Advantage plan?
Medicare Advantage (MA), also known as Medicare Part C, comes with all the same benefits as Part A and Part B, but adds valuable extras including vision, hearing, dental benefits, and prescription drug coverage. Medicare Advantage consists of insurance plans offered through Medicare-approved private health insurance companies. Advantage plans include additional benefits like lower cost sharing and a limit on out-of-pocket expenses. Patients must seek treatment in network to enjoy the full benefits of Part C coverage.
What’s the Advantage (and not) of Medicare Advantage?
Most Part C plans have you covered for prescription drugs, unlike Original Medicare. Plus, you get these extra benefits:
A Medicare Advantage plan with drug coverage is a smart option if you’re considering enrolling in Medicare Part D but can’t afford the premium.
Is Medigap insurance worth the cost?
The security of having lower or no out-of-pocket healthcare costs can offset the premiums you’ll have to pay for whichever Medigap plan youchoose, which vary depending on the benefits offered.
Your Medigap Benefits
Wherever you live in the U.S., Medicare Supplement providers have to offer identical and standardized benefits. For instance, Plan C in New York has to match up with the benefits available in Indiana’s Plan C. The exception to the rule is for people in Massachusetts, Minnesota, or Wisconsin, whose Medigap plan options are unique to those states.
No matter your location though, all plans must cover some of these basic benefits:
Specific plans offer expanded benefits. The most complete Medigap insurance plan, Plan F, covers these added items:
How can I choose the best Medicare coverage plan for me?
No two patients are exactly alike. Each of us has a different set of needs when it comes to the right health insurance coverage. You’re not just looking for the best Medicare Plan—you’re looking for the best Medicare Plan for you!
Your search for the right insurance plan should be a personalized experience. Connect with a trusted insurance agent and get the one-on-one support you deserve. A qualified advisor will help you better understand all of your options, including benefits from a former employer, military service benefits, Medicaid coverage and more.
An agent will also help you answer questions about your personal health and family history so you can choose a coverage option that both manages your risk and minimizes your cost. This is also your opportunity to ask any and all questions, whether you wish to learn more about Medicare insurance cost-sharing, explore supplemental insurance options, or get a quote for prescription drug coverage.
Contact one of our agents today, or fill out a form for a free consultation, and get the support you need to make the right Medicare coverage decision for you.
Still confused? Call us!
Table of Contents
It depends on your specific needs, but for most people a Medigap plan is very useful in supplementing the coverage of Medicare Part A and Part B. A Medicare Advantage plan is an affordable way to get healthcare coverage not offered by Original Medicare.
It’s hard to argue against plans which cut your traditional Medicare costs. For most people, having the extra coverage these supplemental plans provide is common sense, unless they want the specific features of a Medicare Advantage plan.
Most people would benefit from not having to pay out-of-pocket to stay healthy. Medicare supplement insurance or a Medicare Advantage plan offer vital savings now, but are indispensable should a catastrophic health issue occur.
Historically, Plan F has been the most popular because it covers all the out-of-pocket costs Medicare does’t pay for. This includes the 15% extra charge billed by providers who do not take Medicare as full payment.
- Best overall Medicare supplement for new enrollees: Plan G
- Best overall Medicare supplement before 2020: Plan F
- Best low cost Medicare supplement: Plan K
- Best alternative to Plan G Medicare supplement: Plan N
Before getting a Medicare supplement plan, you need to be enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance). People with Medicare Advantage Plans who want to go back to Original Medicare can buy a Medigap policy prior to switching.
With Medicare Advantage, you’ll be required to pay for most of your healthcare expenses as they arise. This differs from Original Medicare, were you’ll pay most costs upfront. This can make it difficult to anticipate the actual cost of your healthcare coverage in advance, and consequently, can be difficult to manage on a fixed budget. Therefore, while Medicare Advantage can result in savings, it is really recommended for those with a good health outlook who don’t anticipate many healthcare visits over the duration of coverage.
You may be eligible for aMedicare Supplementinsuranceplan, but you mustfirst unenroll from Medicare Advantage and subsequently enroll in Original Medicare. Provided you do so during the Annual Election Period (AEP), between October 15 and December 7, you should be eligible for a Medicare Supplement Plan. But you should be aware that this switch will result in the loss of your Medigap “guaranteed-issue” rights, which otherwise remain in place for six months when you are both 65 or older and enrolled in Medicare Part B, and which protect your ability to buy any plan sold in your state without facing higher premiums as a consequence of your health status.
Medicare gives you the flexibility to drop your Part C plan any time you want during the next 12 months and return to Original Medicare.
Medicare Supplement policies are private health insurance designed to cover gaps in Original Medicare. They are also known as Medigap plans. These take care of costs such as copays, coinsurance, and deductibles which can become expensive if you need regular care from a doctor or hospital. If you need medical care while traveling outside the U.S., you can buy Medigap policies to help cover those costs. As a supplement to Original Medicare, you’re required to have Part A and Part B before you canget a Medigap policy. This way, Medicare is responsible for the Medicare-approved costs of the covered care, and the remainder is covered by your Medigap plan.
Optimal coverage comes with higher costs, making Plan F the most expensive Medigap plan. Plan F is known as “first-dollar coverage” and it takes care of everything provided during a doctor or hospital visit. Your only responsibility is for dental, vision, medications, and equipment, such as hearing aids.
Since Plan F was discontinued for new enrollees as of 2020, Plan G offers the most coverage for people 65 and older. It has a lower premium than Plan F and duplicates its benefits, except for the Part B deductible.
The Federal government ended the Plan F option for new enrollees last year to keep the healthcare system from being overused by patients who had their deductibles covered. The next best coverage after Plan F is Plan G.
Medigap Plan G offers every advantage of Plan F except for the deductible, which you have to cover. Because it isn’t as comprehensive as Plan F, Plan G is more affordable.
For people who don’t go to the doctor often, Plan K is worth considering. It is the most affordable because it provides just 50% of Medicare Part B coinsurance, the Part A deductible, blood, skilled nursing, and Part A hospice costs. For comparison, Plan G and others offer full coverage of these expenses, and more.
Of the 10 Medicare-approved Medigap plans, Plan G and Plan N are the most popular. Plan F is no longer available to new Medicare enrollees as of 2020, but it is still popular among people who bought this plan prior to 2020.
- Plan F$128–$342
- Plan F (high deductible)$22–$88
- Plan G$106–$325
- Plan G (high deductible)$29–$58
The security of having lower or no out-of-pocket healthcare costs can offset the premiums you’ll have to pay for whichever Medigap plan you choose, which vary depending on the benefits offered.
The national average cost for Medicare Supplement Plan F is $1,824 annually, which is $152/month; Medigap Plan G will cost you around $143 per month.