Medicare Enrollment: What’s the Difference Between an Advantage Plan and a Supplemental Plan?

Medicare Enrollment: What’s the Difference Between an Advantage Plan and a Supplemental Plan?

Medicare Advantage and Medicare Supplemental plans. While you would think that these two plans are similar with very little difference, they are actually quite stark in their variety. But there is little doubt that, even with their differences, one of them is definitely right for you. 

Which should you choose? First, you need to understand the differences between Medicare Advantage and Medicare Supplements. Once you are aware of these contrasts you will be more easily able to determine which one fits you best.

So, what are the major divergences between Advantage and Supplement?

Medicare Advantage

Medicare Advantage programs (Sometimes called Medicare Part C) are provided by commercial insurance providers, and are similar to a traditional HMO or PPO plan you may have received from an employer. Advantage plans are required to provide the same base benefits as Original Medicare (Parts A and B). Some advantage plans also offer prescription drugs, hearing, vision, or dental coverage. Although your monthly premiums may be lower with an Advantage plan, your out-of-pocket costs like copays and coinsurance may be higher. Part C plans typically offer a limited network of doctors and providers– and as a result may not cover you on an out of state trip. The limited availability for Advantage beneficiaries can give many people a headache. But the other most common issue for many consumers is that they were unable to correctly anticipate their out-of-pocket expenses when they used their Advantage plans. 

To enroll in a Medicare Advantage plan, you must:

  • Be enrolled in Original Medicare (Parts A and B)
  • Live in the service area of the Medicare Advantage plan you’re applying for
  • Be a U.S. Citizen or legal resident

Medicare Supplements

Medicare Supplemental plans (often called Medigap) are also available from commercial insurance providers. These plans will cover the same health-related items and services covered by Original Medicare, but will provide payment for these services above and beyond your plan. Depending on the Medigap plan, you may never even need to pay copays or coinsurance, unlike Medicare Advantage. These sorts of supplementary Medicare plans allow you to budget ahead of time. They also have a far broader network of providers, which includes any doctor that accepts Medicare assignment, which is the case for the vast majority of doctors in the United States. 

After comparing Medicare Advantage and Medicare Supplements you can see there are some stark and important differences between these two different types of plans. Depending on your location, health conditions, providers, prescriptions, financial situation and other factors, one or the other might be more beneficial for you. If you have questions about which is right for you, you should contact us immediately at 385-422-2500 or email directly at rrahlf@youroasisadvisor.com. We are eager to connect you with professionals who can assist you with your Medicare insurance needs.