Comparison Between Medicare Supplement Plan and Medicare Advantage

Introduction

Medicare Supplement Plans and Medicare Advantage plans are offered by private insurance companies and they complement the Original Medicare. The Original Medicare does not meet all the expenses of healthcare for meeting which the customers have to purchase the Medigap policies or the Medicare Advantage plans. The salient differences between the two are provided below:

 

Standardized Plans

The Medigap plans are standardized and regulated by the Federal authorities. The plans are standardized and a specific plan will offer the same standard features and benefits to the customers irrespective of the location of state within the US. The customers do not have to bother from which insurance company they buy the policies as they will be standardized. The Medicare Advantage plans are not standardized plans and the benefits may vary from different insurance companies.

 

Guarantee Issue

The Medicare Supplement plans can be guaranteed to be issued by the insurance companies only when the applicant applies in the Open Enrolment Plan (OEP) or they have guaranteed issue rights. In other cases, the insurance company can reject to sell the policy based on medical history and pre-existing health conditions. Medicare Advantage plans are available to everyone who have Medicare Part A and Part B.

 

Cost

Medicare Supplement plans have higher monthly premium compared to the Medicare Advantage. However, the Medigap policies have the added advantage of lower out-of-pocket expenses for the customers. The Medicare Advantage costs less than the Medigap policies and has higher service coverage.

 

Network of Doctors and Hospitals

Generally, the Medicare Supplement plans do not limit the customers to visit the doctors or hospitals in their network to avail the policy benefits. The customers can visit any healthcare service provider they are comfortable with as long as they accept the Medicare. Medicare Advantage plans on the other hand limit the customers to visit the doctors and hospitals in their network for availing the policy benefits. Clearly, the Medigap policies provide greater flexibility to the customer in accessing the healthcare facilities for enjoying the policy features and benefits.

 

Benefit Access in Outstation

Medicare Supplement plans provide the flexibility to the customers to avail policy benefits across any of the states in the US. Some Medigap plans also cover the emergency care expenses of the customers in foreign countries. Medicare Advantage plans though, work and offer the benefits to the customers in certain locations only. It will not offer the benefits to the customers in different outstation states or foreign countries.

Includes Prescription Drug Coverage

Medicare Supplement plans do not provide prescription drug coverage. The Medicare Advantage plans offer prescription drug coverage to the customers.

How Much You Pay For Medicare Supplement Plans To Get 100% Coverage?

How Much You Pay For Medicare Supplement Plans in 2019 To Get 100% Coverage?

 

You can’t take any risk of your life. When your health or life is a threat you are willing to pay any amount to hospitals and doctors. This won’t be a problem if you are a billionaire. But what if you don’t have such a huge amount of money, you have to borrow or lend.

Having a health insurance policy is the key to your health relief. At any medical emergency, your Medicare policies cover up to 80% of expenses. You just need to buy Medicare plans and pay your premiums. While 80% medical cost is covered by government insurance policies, rest 20% is covered by private insurance policies. So you will get the coverage of 100% medical costs at your health risk.

You don’t have to pay a single penny from your pocket.

What do you need to do to get 100% coverage?

You have to buy both Medicare Part A and B which will cover your hospital and medical service costs. To cover remain 20% you should buy Medicare supplement plans.

What are the factors to calculate the premium amount?

  • Check State insurance policy whether it offers the same plan or it has other plans and facilities too. This also affects the premium.
  • Medicare part A and B have different premium value but can be payable together. In other hands, Medigap’s premium is payable differently.
  • Age when you apply for Medicare supplement plans. Basically, it started at the age of 65 and has the same monthly premium amount.
  • Premium amount also depends on which plan you choose. Premium is different for each plan.
  • Every state has a different premium.
  • If you want extra facilities like drug coverage or/and foreign travel health coverage premium will increase.

How much difference you can get in Medicare supplement plans?

  • Plan F: $149 – $180/month (Texas), $169 – $190/month (Los Angeles), $275 – $336/month (Miami)
  • Plan G: $116 – $134/month (Texas), $142 – $172/month (Los Angeles), $255 – $300/month (Miami)
  • Plan N: $94 – $120/month (Texas), $113 – $150/month (Los Angeles), $198 – $248 /month (Miami)

Now you can understand that how much different premium can be. You have to pay according to location and selected Medicare supplement plans.

Apart from that, you have to pay for Medicare Part A and B too.

Part A premium – an average amount of part a premium can be $232 – $422/month depending on the quarter.

Part B premium – it is cheap in comparison to the other part which is $130 -$135/month.

However, states insurance policy can affect the premium amount.

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