Medicare Supplement / Medicare Advantage Plans

Individuals insured by Medicare often need additional coverage to help cover the costs of medical procedures and prescription drugs. Those who are eligible for either a Medicare Supplement or Medicare Advantage plan often have difficulties determining which plan to choose. With so many options and so many different carriers to choose from, this process can often be very difficult.

The following information will attempt to clear up some of the confusion of Medicare. Keep in mind that there is way more information on Medicare Supplement and Medicare Advantage Plans and the advice of a professional should be considered before making any decisions.

Do I qualify for a Medicare Supplement or Medicare Advantage Plan?

If you’re 65 or older and are currently enrolled in Medicare Part A and Medicare Part B, you are eligible

There are 4 Parts to Medicare

  • Part A — Original Medicare. This pays for Hospital Insurance. You receive Part A as soon as you turn 65, without paying any monthly premium.
  • Part B — Medical Insurance. Part B requires a monthly premium, it is an optional feature. The monthly premium typically comes out of your Social Security Check.
  • Part C — Medicare Advantage. These policies vary from company to company. It is important to meet with an independent agent to find the Medicare Advantage plan that is best for you. The two most common types of Medicare Advantage Plans are a HMO and PPO plans.
  • Part D — Prescription Drug coverage. Medicare Part D can be purchased on its own, or as part of a Medicare Advantage Plan.
  • There is an additional option, Medicare Supplement, also known as Medigap. There are 10 Medigap policies, named A-N. These policies are standardized by the government. The only difference between Medigap plans from one company to the next is the price of the premiums.

Can I have both a Medicare Supplement and Medical Advantage Plan?

No, you may choose either a Medicare Supplement or Medicare Advantage Plan, you can not have both.

What is the difference between an HMO and PPO?

HMO (Health Maintenance Organization) – In an HMO, you must select a primary care physician who is responsible for mananging and coordinating all of your health care. You must choose doctors, hospitals, and other providers within the HMO network

PPO (Preferred-Provider Organization) – The plan has contracts with a network of providers. You do not need to select a primary care physician and do not need a referral to see other providers in the network. You can choose doctors, hospitals, and other providers within the PPO netowrk or from out-of-network. Out-of-network, you will likely pay more.