Comparing Medicare Supplemental Options

Now that you are enrolled in Parts A and B you should analyze your options for Medicare Insurance.  Basically you have two options, a Medicare Supplement or a Medicare Advantage plan.

Below is a general comparison chart for these two types of medicare insurance. Each one has it’s pros and cons.  Take a look at this chart and see if one is more compelling for you.

 

 
Medicare
Supplement
Medicare
Advantage
EligibilityMust be enrolled in Medicare Part A and B. All applicants must be accepted during Medigap Open Enrollement and Guaranteed Issue Periods. Outside of this time insurance carriers can deny coverage and rate up the premiumsMust be enrolled in Medicare Part A and B and live in the service area of the provider. Can enroll when first enrolled in Medicare, otherwise enrollment is during Annual Enrollment Period (Oct 15th - Dec 7th). All applicants are accepted unless they have End Stage Renal Disease.
What are the premiums?Premiums range from $90 - $200 depending on age, health, tobacco use, location, and plan chosen.$0 to more than $100 a month depending on the plan. All plan enrollees pay the same regardless of age or health history.
What are the Out of Pocket costs?Plan F offers 100% medical coverage.

Plan G covers 100% as well with the exception of your annual Part B deductible which is $147.
In-network medical deductibles and copays of up to $3,400 to $6,700 a year, depending on the plan and carrier. Out of network exposure can be unlimited depending on the plan.
Healthcare Provider OptionsThere is NO network. As long as your provider accepts Medicare they accept the plan regardless of the carrier. No referrals for specialist required.HMOs and PPOs are the most common provider networks.

HMO: Generally in-network coverage only. Will need referrals from primary provider for specialists.

PPO: No referrals needed. Covers out of network. Plans have higher premiums but offer more flexibility.
When can you buy?First six months after you sign up for Part B and are at least 65 years old. After that, in most states you can be turned down or charged extra for pre-existing conditions. You can change mid year if the new company approves you.When you first enroll in both Medicare A and B and annually thereafter during Annual Enrollment (Oct. 15-Dec. 7). Can change mid year if you qualify for a Special Enrollment Period.
Are prescriptions covered?Prescriptions are not covered.

You can enroll in any PDP (Part D - Prescription Drug Plan) of your choice.

We will assist you in choosing your Part D plan.
Prescription coverage is most often included but you must make sure that it is a MA-PD (Medicare Advantage Prescription Drug) plan. Some carriers offer Medical only coverage.

Very important to make sure that your prescriptions are covered under the formulary (and how much will they cost you?) before finalizing this coverage.
What cards are in my wallet?Usually 3 cards:
1. Red, white and blue Medicare Card.

2. Medicare Supplement card

3. Part D card
Usually just one Medicare Advantage card. The red, white, and blue Medicare card can stay in your desk drawer.
Which one is best for me?Don't want to deal with copays and coinsurance amounts. Like the idea of having 100% coverage (Plan F) for Medicare approved claims, giving you $0 out of pocket exposure.

This plan is ideal for people that travel often, live near a state line and may seek care across the state line, or may live in another state for a period of time throughout the year.

Choice of any doctor anywhere you want (as long as they accept Medicare).
Main goal is to save on monthly premiums and understand the out of pocket exposure of the plan.

If you don't live elsewhere during portions of the year and have access to doctors in the HMO or PPO.

Want a "packaged plan" that includes both medical and prescription coverage.

If you would like to work with us, simply click here (why work with us) to see how we service you.