Medicare Supplement Plans and Medicare Advantage Plans Are Not the Same
Medicare Advantage Plans, are health plans from insurance companies that have a contract with CMS (Center for Medicare and Medicaid). People with Medicare Part A and B are eligible to choose a Medicare Advantage plan. There are specialized plans for people with certain health conditions, but beyond that, general plans cannot decline for health reasons except for very specific reasons.
When a person joins the plan, they don’t lose their Medicare. They have the right to cancel their Medicare Advantage plan and can return to Original Medicare the following month. While enrolled in Medicare Advantage, they will need to use the insurance card provided by the Medicare Advantage plan instead of their Medicare card.
These plans can cost participants little or nothing, although many still require the Part B participation amount. However, a Medicare Advantage plan is not free. Plans receive a contribution from CMS every month, instead of tax money going to Original Medicare. This is how most of the plan is paid for, with tax money.
Traditionally, Medicare Advantage plans were thought of as HMO plans in which an insured person had to use the plan’s hospitals, doctors, and other medical providers to be covered. Many Medicare Advantage plans are HMO plans. However, there are also PPO Medicare Advantage plans. Medicare Advantage fee-for-service plans, or plans that will cover any medical provider that accepts insurance, are aggressively marketed these days.
Your own medical needs and preferences will determine which plan will work best for you. If your current medical providers are contracted with the plan’s HMO, then you can be very satisfied with comprehensive coverage with very few additional payments. If you want more options and doctors in the area will accept a Free For Service plan, then you might consider an “Any Doctor” plan. Note that not all doctors work with fee-for-service plans, although the insurance company claims it will work with any doctor! PPO plans provide a great commitment. You get the most coverage at the lowest price in the network, but you will still be covered by other medical providers.
Most, but not all, Medicare Advantage plans also contain Part D or prescription drug coverage. Medicare Advantage plans can have little or no premium for insured people beyond their normal Part B premium. Some plans even reimburse the Part B premium. Also, Medicare Advantage plans can’t make a huge selection. risk based on health, so they can be a good option for less healthy applicants.
A traditional Medicare supplement it is very different from Medicare Advantage. With Medicare Supplements, you still use your original Medicare card and add your Medicare Supplement Health Card. These plans are also provided by insurance companies, but simply supplement the coverage gaps and deductibles that Original Medicare Part A and Part B do not provide.
If you have Medicare Part A and Part B, your Medicare supplement plan will pay the part of your medical bill that Medicare won’t pay. Of course, Medicare supplement plans differ, so you need to know exactly what parts a Medicare supplement plan will pay for before you sign up. For example, Medicare may represent 80% of the hospital bill and your supplement will take care of the remaining 20%.
Medicare supplements come with premiums and can also exclude sick people. However, they generally provide the widest access to medical care.
