Jane Dotson
Medicare Advantage, also known as Part C, is an alternative to Original Medicare (Parts A and B) and offers another way to get your Medicare coverage. Supplemental insurance, also known as Medigap, is additional insurance that can be purchased from a private company to help pay for out-of-pocket costs associated with Original Medicare. While Medicare Advantage and Medigap both relate to Medicare coverage, they serve different purposes. This paragraph will explore the relationship between Medicare Advantage and supplemental insurance (Medigap) and answer the question of whether Medicare Advantage replaces Part F supplemental insurance.
| Characteristics | Values |
|---|---|
| Medicare Advantage Plan | Medicare Advantage Plan (Part C) is an alternative to Original Medicare |
| Original Medicare | Includes Part A and Part B |
| Medicare Advantage vs Original Medicare | You can choose either a Medicare Advantage Plan or Original Medicare for health coverage |
| Medicare Advantage and Medigap | You can't have both a Medicare Advantage Plan and a Medigap policy at the same time |
| Switching between Medicare Advantage and Medigap | If you switch from Medigap to Medicare Advantage, you have a 12-month trial period to switch back to Medigap |
| Medigap and prescription drug coverage | Medigap plans sold after 2005 do not include prescription drug coverage; you need to join a separate Medicare drug plan (Part D) |
| Medigap and Part B deductible | Medigap policies do not replace Medicare Part B; you must have Part A and Part B first before enrolling in a Medigap policy |
| Medicare Supplement Plan F | Covers all Part B excess charges; you won't pay the standard 15% excess charges for Part B services |
| Medicare Supplement Plan F vs G | The coverage is similar, with a minor exception in the Part B deductible; some clients save $200-$300 per year by choosing Plan G |
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What You'll Learn
Medicare Advantage vs. Original Medicare
Medicare Advantage, also known as Part C, is a Medicare plan issued by private insurance companies. It is an alternative to Original Medicare, which is federal health insurance for anyone aged 65 and older and some people under 65 with certain disabilities or conditions. Original Medicare includes Part A and Part B, which can be supplemented with a separate Part D plan for prescription drugs and Medigap for deductibles and copayments.
Medicare Advantage plans may have lower premiums, but they have different copayments and deductibles than Original Medicare. They also have limited networks of doctors and may not pay for out-of-network providers. By contrast, Original Medicare allows you to use any doctor or hospital that accepts Medicare anywhere in the US.
Medicare Advantage plans often provide extra benefits that Original Medicare does not, such as prescription drug coverage, dental, hearing, and vision care. However, they may have prior authorization requirements and restrict your access to specialists without a referral from your primary care physician.
When choosing between Original Medicare and Medicare Advantage, it is important to consider your specific health needs and preferences. Original Medicare offers more flexibility in choosing your healthcare providers but may have higher out-of-pocket costs. Medicare Advantage plans provide more comprehensive coverage, including prescription drugs and additional benefits, but they have geographic limits and may restrict your choice of doctors.
Supplemental insurance, such as Medigap, can be purchased separately to help with the out-of-pocket costs associated with Original Medicare. These policies are standardized, and the benefits are the same regardless of the insurance company. On the other hand, Medicare Advantage plans are issued by private insurance companies and may vary in their specific offerings, but they provide all-in-one coverage, including Part A, Part B, and sometimes Part D.
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Medigap policies
Medicare Advantage, also known as Part C, is one way to get Medicare benefits through private insurance companies approved by Medicare. On the other hand, Medigap policies, also known as Medicare Supplement Insurance, are sold by private insurance companies to fill in the gaps in Original Medicare coverage.
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Medicare Supplement Insurance Plan G
Plan G has a high-deductible plan option. With this option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,870 before your plan pays anything. You must also pay a separate deductible of $250 per year for foreign travel emergency services. High-deductible policies have lower premiums, but if you need to use your benefits, you may have higher out-of-pocket costs.
The benefits in each lettered plan are the same, no matter which insurance company sells it. When you first sign up for Medicare and during certain times of the year, you can choose how to get your Medicare coverage. There are two main ways: Original Medicare, which includes Part A and Part B, or a separate Medicare drug plan to get Medicare drug coverage (Part D). You can also shop for and buy supplemental coverage that helps pay your out-of-pocket costs.
Medicare Advantage is an alternative to Original Medicare. Medicare Advantage plans often have different out-of-pocket costs than Original Medicare or supplemental coverage like Medigap. Plans may offer some extra benefits that Original Medicare doesn’t. Medicare Advantage plans are run by private insurance companies that follow rules set by Medicare.
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Prescription drug coverage
Medicare Advantage, also known as Part C, is a Medicare-approved plan offered by private companies as an alternative to Original Medicare. These plans include Part A, Part B, and usually Part D, which covers prescription drugs. In many cases, you can only use doctors within the plan's network.
Medigap, or Medicare Supplement Insurance, is extra insurance that helps pay your share of costs in Original Medicare. Medigap policies generally do not cover prescription drugs. If you want prescription drug coverage, you can join a separate Medicare drug plan (Part D).
Medicare Advantage Plans typically include drug coverage (Part D), which is provided by private insurance companies that follow rules set by Medicare. These companies divide covered drugs into tiers based on cost, with lower tiers costing less than higher tiers.
If you have Original Medicare and want to add drug coverage, you can join a separate Medicare drug plan. This is optional and available to everyone with Medicare. However, most Medicare Advantage Plans do not allow you to join a separate drug plan.
When deciding between Original Medicare and Medicare Advantage, consider that Medigap policies may offer more flexibility in choosing healthcare providers, while Medicare Advantage Plans often have different out-of-pocket costs and may provide extra benefits not covered by Original Medicare, such as certain vision, hearing, and dental services.
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Eligibility and enrollment
Medicare is federal health insurance for anyone aged 65 and over and some people under 65 with certain disabilities or conditions. Medicare Advantage Plans (also known as Part C) are offered by Medicare-approved private companies and follow rules set by Medicare. To be eligible for Medicare Advantage, you must have Part A and Part B of Original Medicare. You can then choose to join a Medicare Advantage Plan with or without drug coverage (Part D).
You can only join, switch, or drop a Medicare Advantage Plan at certain times, known as enrollment periods. These enrollment periods include your Initial Enrollment Period, during which you can change to another Medicare Advantage Plan or go back to Original Medicare within the first 3 months of having Part A and Part B coverage.
To enroll in a Medicare Advantage Plan, you will need your Medicare Number and your Part A and/or Part B coverage start dates, which can be found on your Medicare card. You can select "Enroll" for your chosen plan at Medicare.gov/plan-compare, contact the plan directly by phone or through their website, or request a paper form to fill out and mail back.
It's important to note that Medicare Advantage Plans may have different out-of-pocket costs than Original Medicare or supplemental coverage. You may also incur an additional premium. Review the costs, including monthly premiums, deductibles, and estimated yearly costs for any drugs you take. If you have other health insurance or drug coverage, consult your benefits administrator before making any changes to your current coverage.
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Frequently asked questions
Medicare Advantage is another way to get your Medicare coverage besides Original Medicare. Original Medicare includes Part A and Part B.
Medigap is a supplement to Original Medicare coverage. You can either buy Medigap or enroll in a Medicare Advantage Plan, but you can't have both.
No, it does not replace Part F supplemental insurance. If you drop a Medigap policy to join a Medicare Advantage Plan, you have a single 12-month period to get your Medigap policy back.
