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Are you confused by Medicare Advantage Plans vs. supplemental insurance? You’re not alone. In this quick guide, we explain the differences and advantages of each.

Medicare Supplement Plans are one of the two ways to protect yourself financially from the shortfalls or “gaps” in original Medicare coverage.  The gaps in Medicare refer to the health care expenses that you must pay out of your own pocket. Medicare Supplemental Insurance plans are the second way to protect yourself financially from the gaps in Medicare.

In this post we are going to explain Medicare Advantage Plans in easy to understand terms, and highlight the benefits of Advantage Plans over Medicare Supplemental Insurance plans.

The Key Feature of Medicare Advantages Plans

In case you don’t have time to read this whole post let us say that in a nutshell, the key features of Medicare Advantages Plans are:

  • Lower cost – Advantage Plans can be cheaper than Medicare Supplemental Insurance.

  • Prescriptions are covered – Most Advantage Plans cover the cost of prescription medications.

  • The Advantage Plan pays your health bills, not Medicare – You purchase a Medicare Advantage Plans from commercial health insurance providers like Anthem, Humana, Kaiser, etc.  Medicare pays the provider for most if not all of the premium for the Advantage Plan. The Advantage Plan is then responsible for paying your health care expenses. 

How Does a Medicare Advantage Plan Work?

A Medicare Advantage Plans are offered by Medicare-approved private companies that must follow a set of rules defined by Medicare. If you join a Medicare Advantage Plan you get your coverage for Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) from the Medicare Advantage Plan, not Original Medicare. 

As an independent Medicare insurance broker in Colorado Springs we know there exists a range of private insurers in Colorado Springs that have a contract with Medicare to offer this type of coverage. 

These plans have to offer identical benefits to Medicare Parts A and B as a minimum. Different plans offer different levels of coverage, so checking the extent of coverage is wise before taking out a policy.

Most Medicare Advantage Plans include Medicare prescription drug coverage (Part D) as well as other benefits. These benefits often  include health insurance coverage for routine dental, and vision coverage, as well as wellness programs (which are becoming very popular in Colorado Springs). 

There are also plans specifically designed for those with special health-care requirements. Medicare Advantage Plans are ideal for those with chronic conditions, such as congestive heart failure or diabetes.

What Do I Need to Know About Medicare Advantage Plans?

Coinsurance, copayments, and deductible amounts vary depending on which plan you take out. The premiums will also vary, with some premiums being as little as $0. There are a few things you need to know, though.

  • Medicare Advantage Plans provides all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage.

  • Medicare Advantage Plans limit the total amount of out-of-pocket expenses you’ll need to pay for the covered services throughout the year. As a result, your costs won’t mount up and get out of control.

  • Depending on which type of Medicare Advantage Plan you take out, you may need to use specific providers. There may be an approved network of providers to pick from to receive your full plan benefits. For example, if you live closer to the East side of the Springs you would go to Penrose St. Francis for any hospital needs. But, the plan you get may only cover services at Memorial North. 

  • You need to be a resident in the service area for your plan.

  • If you take out Medicare Advantage coverage, you won’t need Medicare Supplemental coverage.

No Health Questions – An Attractive Feature

One of the top features of a Medicare Advantage Plan is that it only asks a single health question. Therefore, it is very rare for someone not to receive coverage. However, some individuals will not be able to obtain this kind of plan. For example, people suffering from end-stage renal disease cannot purchase a Medicare Advantage Plan.

You should certainly note that it’s only possible to enroll in a Medicagre Advantage Plan at specific times. Don’t wait until you get ill before you try to get coverage for this reason. If you miss your first enrollment window you have another chance during the year. The time between October 15th and December 7th is the AEP, or Annual Election Period. You can enroll during this period every year.

Summary

It’s always wise to enroll in Medicare Advantage Plans before you need to use them. Don’t get stuck with massive medical bills you could have avoided. And if you’re still unsure what the best option is for you, contact us for a free quote on the best Medicare plan for you or a loved one. 

Call (719) 599-7989

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More to Read on Colorado Medicare

How Does Medicare Supplemental Insurance Work?

Download the Official Medicare Handbook 

Medicare Costs at a Glance