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You're new to Medicare. You're already on a Medicare Supplement and Original Medicare. Whatever the scenario, it's all very confusing if you have never had any of this thoroughly explained. You've heard a lot about Medicare Advantage Plans and wonder, "What is the difference between a Medicare Advantage Plan and a Medicare Supplement also known as Medigap Insurance."
Medicare Advantage Plans are considered Private Insurance and they offer several benefits that you won't get with Original Medicare and Supplemental Plans. Most Advantage Plans offer extra benefits like hearing, vision, dental options, gym and fitness memberships, quarterly over the counter allowance to name a few. Some advantage plans offer a Part B Buyback. Medicare Advantage Insurance Carriers are required to cover at least what Original Medicare Covers. Medicare Advantage Plans also have a maximum out of pocket dollar figure. This means that once you've met your "MOOP" Max Out of Pocket, your plan pays 100%. Medicare Advantage Plans also include a Part D Drug Plan. The drug plan doesn't fall into the "MOOP" 100% that is for the hospital and medical portion of your policy. The Part D Drug Plan that is included in your Medicare Advantage works the same as a stand alone PDP Drug Plan except the premium is included in the Medicare Advantage Premium. Some Medicare Advantage Plans have a low to no cost premium. Medicare Advantage Plans are Service Area Specific so if you move out of your zip code service area, you will have to enroll into a new plan based on your new zip code. Some Medicare Advantage Plans are PPO Plans which means you can use out of network doctors. Some Medicare Advantage Plans are HMO Plans which means you need to use in network doctors only. If you're travelling Medicare Advantage Plans are required to cover Emergency Care as in network anywhere in the USA if you're out of your service area.
Medicare Supplemental Plans also known as Medigap Plans go together with your Original Medicare. Although not required, a Medicare Supplemental plan helps to cover the 20% that Original Medicare doesn't cover. It also helps with other out of pocket expenses that come with Original Medicare. There is no cap on your out of pocket expenses you can incur with Original Medicare if you do not have a supplemental plan. Medicare Supplemental Plans are good in any facility in the US that accepts Medicare. Most people that have a Medicare Supplement would also have a stand alone prescription drug plan as well. All requiring separate premiums.
The exception to having a stand alone drug plan is usually for veterans or people that have other drug coverage like VA, Tricare or you may still have drug coverage through a spouses workplace insurance or your own workplace. People with other creditable drug cover can look at a Medicare Advantage Only Plan also known as MA Plan.
If you want to discuss your options, please give us a call toll free at 1-855-410-7807 or local 509-223-6038. There is never a charge to you for our help. We are licensed and certified by all the carriers we work with on a yearly basis.
(Disclosure) we are compensated by the carriers with a small monthly commission. This does not affect your premium.