All Medicare Advantage, Medicare Advantage-Prescription Drug: Fill & Download for Free

In the simplest terms: Medicare Advantage changes the way your Medicare payments work, while Medicare Supplement gives extra coverage beyond Medicare.The Key PointsMedicare is a federally administered health insurance program for people aged 65 and older.Medicare Advantage and Medicare Supplement are both administered by private insurers.Medicare Advantage is an alternative option that largely replaces Medicare. It offers more flexibility in balancing costs and coverage.Medicare Supplement is an extra option that works alongside Medicare. It covers healthcare costs not covered by Medicare.In many cases you can’t have Medicare Advantage and Medicare Supplement plans at the same time. Even if you can, it’s usually a very bad idea financially.TerminologyAs well as having similar names to Medicare, Medicare Advantage and Medicare Supplement can be confusing because of two different sets of letters. The key is to remember the difference between parts and plans:Medicare comes in four parts: A, B, C and D. (Medicare Advantage is another name for part C.)Medicare Supplement is also called Medigap. It comes in ten different plans called A, B, C, D, F, G, K, L, M and N. (Plans E, H, I and J are no longer available.)Breaking Down MedicareAs QuickMedigap explains, the standard (or “basic” or “original”) Medicare program covers two sets of expenses:Part A covers hospital expenses. For most people who’ve worked and paid taxes, there’s no premium to pay.Part B covers medical expenses such as doctor fees. Most people pay a monthly premium.In most cases, Medicare users pay 20 percent of any covered costs (a system known as coinsurance.) There’s no annual limit.As an alternative to standard Medicare, you can sign up to Part C, better known as Medicare Advantage. This means your coverage is administered by a private insurer. You’ll still need to pay the Part B premium. However, for the other costs you can choose an insurer and plan which suits your needs. Some of the variables in Medicare Advantage plans include:how much you pay in premiums;whether and how much you pay in coinsurance;whether you have an annual limit on how much you pay (and if so, how much); andwhere you can get treatment.Some Medicare Advantage plans will cover vision and dental costs, which standard Medicare doesn’t.Part D of Medicare is coverage for prescription drugs. With standard Medicare, Part D is an optional extra that you pay for. Medicare Advantage plans often include Part D coverage in the price.Breaking Down Medicare SupplementMedicare Supplement plans cover some medical and hospital costs that Medicare doesn’t cover. You can choose between 10 standardized plans (each named with a letter), though not all insurers offer all 10 plans. Only the benefits are standardized: the premiums are set by the insurer so it’s important to shop around.All Medicare Supplement plans cover any coinsurance and other out-of-pocket expenses for hospital treatment, hospice care and medical treatment once you’ve used up the relevant standard Medicare benefits. Other costs covered by some plans include skilled nursing facilities, emergency treatment abroad and blood.As a rough guide, the best plan likely depends on your priority:Plans A, B and C are best for lower premiums (M and N are effectively variations on C)Plans D, F and G are best for more extensive coveragePlans K and L are best for low caps on out-of-pocket expensesInteractionsTechnically speaking, you could have Medicare Advantage and Medicare Supplement plans at the same time. However, a Medicare Supplement plans can’t pay out for any of the costs of buying Medicare Advantage. This means having both plans at once would be hugely wasteful. A couple of measures limit the possibility of a customer being in this situation:Somebody who has a Medicare Supplement plan and then signs up for Medicare Advantage can cancel their Medicare Supplement plan. They then get a 12-month trial period during which they have the right to cancel the Medicare Advantage plan and then return to their old Medicare Supplement plan.If somebody already has a Medicare Advantage Plan, it’s usually illegal to sell them a Medicare Supplement plan.Recapping The DifferencesIn practical terms, Medicare Advantage plans replace standard Medicare while Medicare Supplement plans enhance it.Some Medicare Advantage plans cover dental and vision costs. Most Medicare Supplement plans don’t.Medicare Advantage plans can be very flexible in costs and coverage. Medicare Supplement comes in 10 standardized plans.For more detail on these and some more technical differences, check out QuickMedigap’s guide.

Medicare Advantage plans work very similar to “regular” health insurance plans such as the ones offered by employers or ones purchased on the individual marketplace.Before going any further, what is Medicare Advantage?Medicare Advantage is an alternative option to Original Medicare (Medicare Part A and B). When a person enrolls in Original Medicare, they may instead opt for a Medicare Advantage plan. Although the person remains enrolled in Original Medicare (and must continue to pay their Part B premium), their Medicare Advantage plan essentially replaces their Original Medicare coverage.What does Medicare Advantage cover?By law, Medicare Advantage plans must offer at least the same minimum coverage as Original Medicare. Once that minimum coverage is reached, Medicare Advantage plans may then offer additional benefits on top. These extra benefits can include things like dental, vision or prescription drug coverage.So what’s the “advantage” of Medicare Advantage?The idea behind Medicare Advantage plans is that they can offer consumers a little bit more coverage than what Original Medicare does. While Original Medicare is a one-size-fits-all benefits package, Medicare Advantage allows consumers to shop around for a plan that offers the specific benefits they need. For example, a person who wears glasses may wish to find a plan that offers vision coverage. Or a person with prescription drug needs may find a Medicare Advantage plan that will cover their medications for less money than what a Medicare Part D (prescription drug) plan will.Some additional advantages include:Those enrolled in a Medicare Advantage plan still retain their Medicare rights and protections.You can enroll in Medicare Advantage even with a pre-existing condition (except for End-Stage Renal Disease).Medicare Advantage plans may not charge more than Original Medicare for certain things like skilled nursing facility care, dialysis or chemotherapy.Medicare Advantage plans have an annual limit on out-of-pocket expenses for medical services, meaning that once this limit is reached, the plan holder will pay nothing for covered services.Medicare Advantage enrollment has steadily increased since 2004, with 33% of all Medicare beneficiaries being enrolled in such a plan in 2017.Okay, back to how Medicare Advantage works…As previously mentioned, Medicare Advantage is not too much different than the health insurance plans most people are accustomed to. You’ll pay a monthly premium and likely face some other out-of-pocket costs such as deductibles, copayments and coinsurance. Medicare Advantage plans are sold on the private market so prices and benefits will vary from one carrier or state to the next.Also like other health insurance plans, Medicare Advantage plans come in the same HMO, PPO or other formats as it relates to network restrictions. And Medicare Advantage plans have their own enrollment period, similar to “traditional” health insurance.How can I shop for and compare plans?It’s actually quite easy. Just enter your zip code to see the Medicare Advantage plans available in your area to compare benefits. If you have any questions, you may call the phone number provided 24 hours a day to speak to a licensed insurance agent.

When you enroll in Medicare advantage plans, they basically replace original Medicare and pay for all the same benefits that you would get if you just had original Medicare. However you often get more benefits and instead of paying 20% or a large inpatient deductible for example you pay flat copays which are often less than what you would pay with original Medicare.You also sometimes get supplemental benefits that original Medicare doesn’t pay for such as routine dental or routine vision.And you are right, in many cases the premium is zero dollars. The reason Medicare advantage plans are able to do this is that original Medicare pays them a certain amount per Medicare beneficiary that enrolls in their plan. Additionally, if a member has a lot of health conditions, original Medicare pays them more to have that member on their plan.In essence, the amount of premium Medicare beneficiaries pay to Medicare advantage plans is a very small portion of the income the Medicare advantage plan makes when they enroll in Medicare beneficiaries. It also helps to have a very good mix of healthy members along with some sicker members. The standard rate per Medicare beneficiary plus the additional amount for members that have more health conditions means that if there are enough healthy members the plan can offer a better benefits and still make money.This is confusing but that’s generally how it works.I have worked for a Medicare advantage plus Part D prescription drug plan for 13 years.