Apart from original Medicare including part A and part B, as an individual of Medicare age, you can get additional coverage through both Medicare supplement and advantage plan. Now the question is which one you should choose to get paid for additional healthcare services that are not covered by original Medicare. Here is a brief discussion on how to compare between Medicare advantage plans and supplement plans.
1.Insurance provider Advantage program, also known as part C program, is offered by the private insurance providers. People who are eligible for original Medicare and attained the age of 65 years can apply for this program. If you replace existing Medicare part A and part B plans with an advantage plan, you will get all services provided by parts A and B only except the costs for hospital care.
However, with supplement plans, the coverage sometimes goes beyond the coverage provided by traditional Medicare.
2.Eligibility and registration In case of supplement, you should have already signed up for part A and B. There is an open enrollment time for Medicare supplement or Medigap. The period runs for 6 months from the very month you turn the age of 65 or 6 months from the day you register in part B plan after turning 65. During open enrollment period, the insurance companies usually cant deny any applicant based on his health status.
In case of Medicare advantage plan, you can join the plan during the initial open enrollment period for conventional Medicare. Another open enrollment period starts on 17th October and ends on 7th December, every year. Youre allowed to drop existing advantage plan and get back to the conventional Medicare between 1st of January and last of February.
3.Level of coverage There is no dearth of Medicare supplement plans and coverage; every state controls such plans and sometimes requires certain coverage. The premium payable depends on the level and extent of healthcare services the plan provides.
On the other hand, Medicare advantage offers the services offered by original Medicare. Advantage plans fall into different categories like preferred provider organizations or PPOs that charge less fees for in-network providers, health maintenance organizations or HMOs that require the plan holders to use in-network providers, private fee for service or PFFS that allow the plan holders to visit any physician and special needs plans or SNPs for the patients in need of special care or admitted in nursing home. Moreover, these plans sometimes offer Health Savings Accounts or HSAs to which original Medicare contribute dollars that can be used for healthcare services.
4.Prescriptions Since the launch of Medicare part D, also known as prescription in 2006, supplement plans have stopped providing coverage for prescription medications. Individuals who have registered for part D after January 2006 needed to drop prescription coverage. On the other hand, advantage plans are not obliged to offer prescription medication coverage. If your plan doesnt provide such coverage, you may enroll for part D without paying any penalty.
In terms of the above-mentioned points, you can significantly compare Medicare advantage plans to supplement plans.