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Advantage vs Supplement

Which one is right for you?

Medicare Advantage Plans

STRENGTHS AND WEAKNESSES

Medicare Advantage plans replace your Government-sponsored coverage. This means that the private insurance companies who offer Medicare Advantage plans take on all the risk and claims for your hospital and medical coverage. The government pays the insurance company a monthly amount to subsidize these costs.

You will have one insurance card provided by the insurance company and you will not use your red, white, and blue Medicare card that you received from Health & Human Services (HHS).

Do not throw your Medicare card away! You just won’t need to take it to healthcare appointments or services. 

Strengths:

Premiums
Advantage plans have low premiums – some as low as $0.

Drug Coverage
Advantage plans typically include prescription drug coverage.

Other Services 
Advantage plans often come with additional services like dental, vision, & hearing as well as gym memberships and other perks.

Weaknesses:

Cost Sharing
You will have higher cost sharing with Advantage plans than with Supplement plans, meaning you will have copays and coinsurance that you wouldn’t have with Supplement plans.

Network
Advantage plans have specific provider networks connected with the company or carrier you choose to use. These networks are often strong in certain geographic areas but may be weak in others.

All Benefits Through Carrier
All Advantage plan benefits are subject to the carrier’s rules, exclusions, and processes that will typically be less inclusive than a Supplement plan.

 

Advantage vs Supplement : Video

WHICH IS RIGHT FOR YOU?


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Supplement Plans (Medigap)

STRENGTHS AND WEAKNESSES

Supplement plans pay secondary to traditional Medicare. This means that Medicare picks up the first 80% of Medicare-eligible costs and then the Supplement plan covers the remaining 20%.

You will use your red, white, and blue Medicare card provided to you by Health & Human Services (HHS). You will also carry an additional card provided to you by the insurance company you choose for your Supplement plan.

Strengths:

Cost Sharing 
The most popular Supplement plan (Plan G) has a $233 annual deductible in 2022. Once that is met, you have zero cost sharing responsibility for Medicare-approved medical expenses.

Network 
With a Supplement plan, you are not limited by a network. You will be covered when visiting any provider who participates in Medicare, anywhere in the country.

Secondary to Medicare 
Since Supplement plans are secondary to Medicare, coverage policies, exclusions, and procedures align exactly with Medicare. We have heard many providers comment on their preference in working with Supplement plans over Advantage plans.

Weaknesses:

Premiums 
Premiums are age-based, meaning the older your are, the more expensive. Premiums start around $110 per month and go up depending on the carrier you choose and your age.

Drug Coverage 
Part D prescription drug coverage is not included with Supplement plans. You would need to purchase a Part D drug plan separately. 

Other Services 
Supplement plans do not come with the same additional services as Advantage plans. Bells and whistles like dental, vision, and hearing benefits will not be included with Supplement plans. You can purchase these plans separately.