Medicare Supplements Vs. Medicare Advantage

The age-old debate in the Medicare world is “Which is better? Medicare Supplements or Medicare Advantage?”

The answer is simple. It depends on your needs and budget.

Do not allow Joe Namath on TV, your sibling, neighbor, or doctor talk you into a plan that you cannot afford, or most importantly, does not meet your needs.

Let’s look at the basic differences between the two insurances:

Medicare Supplements

Medicare supplements are popular mainly for one reason: they do not have networks. You can go to any doctor, any hospital anywhere in the United States, as long as the doctor or hospital accepts Medicare. These plans are not HMOs, or PPOs, so no referrals are needed either. In exchange for this flexibility, you will have a monthly premium. In Florida, this will typically average around $180-$200/mo  for the more comprehensive coverage of a Plan G, or $140 - $160/mo for a plan that allows for out of pocket copays, such as a Plan N.

People often go for these plans for one of three reasons:

• Peace of mind – If you are the type of person that needs the peace of mind of having little to no out-of-pocket expenses, this may be the route for you to go. With a Plan G Medicare Supplement, you will have a monthly premium, and a small $226 deductible, after that, 100% coverage.
• Multiple Doctors – Some people have many doctors. If you happen to fall into this category and have more than 4 doctors that you see on a regular basis, then a Medicare Supplement may be the right choice for you. Finding a Medicare Advantage plan with a network that will have all 5 or 6 doctors in it may be difficult. With a Medicare Supplement, you won’t have to worry about this. No networks, no referrals, no problem.
• Travelling – You happen to be a person that travels a lot than having to work with networks, when you are in a different state every month would not be ideal. Approximately 93% of doctors and hospitals nationwide accept Medicare with a supplement, no Medicare Advantage plan comes even close to that. So, if you are RV-ing across the Great Plains, have no worries, because it won’t be hard to find a doctor in your time of need!

Medicare Advantage

Medicare Advantage is popular in Florida. This is because of the low cost, and rich benefits.

Unliked Medicare Supplements, Medicare Advantage plans in Florida often do not have a monthly premium – saving you north of $150/mo. In addition, some plans even refund the Medicare Part B premium that comes out of your Social Security check – saving you another $165/mo.

But what about out of pocket expenses, such as copays? Many plans have $0 copays for Primary Care Physicians, and low copays for Specialists. Furthermore, the Maximum Out of Pocket (that is the most you could possibly pay for medical care in a calendar year), is often only around $4,500.

Yes, you will have networks. Often an HMO, or a PPO. So, it is important to verify your doctors accept the plan. With HMOs you will have to get referrals to see a specialist, PPOs you do not. PPOs will also allow you to go outside the network to see doctors, with a slightly higher copay.

Medicare Advantage plans also often have coverage that Original Medicare, even with a supplement, does not cover. Such as dental, vision, hearing, and chiropractic care. In a nutshell, these privately managed care plans are often similar to plans you might have had through an employer your entire life, so the transition to a Medicare Advantage plan will usually be easy. The only difference is usually, a lower monthly premium, and often, no deductibles.

Conclusion

The decision you make is not written in stone. If you choose a plan, and decide you do not like it, the Annual Election Period, which runs from October 15 – December 7 of every year is a time when you can make changes to your Medicare coverage. Be sure to consider your options every year and be sure to consider all aspects of your needs, such as, prescriptions, doctors, and anticipated medical care.

Medicare Advantage is not for everyone, but neither are Medicare Supplements. Don’t allow someone to bully you into coverage that doesn’t fit your budget and needs.