Medicare Advantage VS Medicare Supplement

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Medicare Advantage VS Medicare Supplement

There is a huge debate about which one is better, Medicare Advantage or Medicare Supplements.  These are two different vehicles that can both produce similar goals for a consumer.  Medicare Advantage and Medicare Supplements are NOT the same thing, although they may achieve similar goals.

Medicare Advantage plans take a more all-inclusive approach to Medicare than Medicare Supplements. Supplements (along with other vehicles) allow Medicare beneficiaries to see doctors that are not in a network.  If the doctor tales Medicare, he normally excepts a supplement (still always ask).  Neither choice is wrong, simply what is better for the individual is the option to look at.

Medicare Advantage relies on a network to service its consumers.  The term network (referring to an HMO) means that that doctors, hospitals, treatment centers, pharmacies and durable equipment suppliers are all part of a network (group) contracted by the health plan to deliver services to their consumers that have the plan at a pre-negotiated rate.  These entities are contracted with the plan to provide these goods and services.  Consumers that have a Medicare Advantage plan, become responsible for the entire bill, if they receive services outside of the network (except in the case of an emergency).  Some plans have many doctors, hospitals, etc. in them.  A person thinking about this option should ask their doctors, pharmacy, etc., if they participate in the plans network.


Also, networks or (HMO’s) produce somewhat of a chain effect, meaning that everyone the Medicare beneficiary see (medically speaking), must participate.  Ask this question of all the places one uses for their medical needs, to avoid excess or unbeknown charges.  Lastly, networks change and participants as well, so periodically check with the plan and its participants to make sure consumers check to avoid surprises.


Medicare Advantage options are modest priced, provide 100% Medicare coverage, not 80% as Original Medicare does.  Some plans provide, dental, vision, gym, and a host of additional wellness benefits above what Original Medicare provides. Some Medicare Advantage plans even provide a prescription drug plan (this option is called a MA-PD or Medicare Advantage with a Prescription drug plan).  The financial, coordinating and additional benefits of some Medicare Advantage plans, may be appealing to some consumers.

On the other hand, some people want the freedom and unrestrictive nature of the Medicare Advantage option and a Medicare Supplement can aid to fulfilling that need.  Some supplements cover the 20% out of pocket, not addressed through Original Medicare.  Each plan A-N provide a variety of benefits.  Cost is a factor associated with each plan also.  Supplements allow people to combine their supplement options with Original Medicare and an individual prescription drug plan.  A doctor, hospital, etc. that excepts Original Medicare, normally excepts supplements too.  It is still always good to ask and check.

Costs are always a factor, concerning health and healthcare.  Medicare supplements may have a higher cost than Medicare Advantage options.  The cost of A Medicare Supplement plan is usually justified due to the freedom of movement they allow their clients.  The supplement cost +PT B Medicare premium+ PDP (prescription drug plan)=Cost of supplement option cost.   Medicare Advantage plans have costs that are (some have) annual deductibles, co-pays and in some cases a monthly premium but normally is less expensive than the previous option.  Please understand that costs are shifting and coverage options may have changed.  Simply look at your options, do not let cost be your driving factor concerning healthcare.

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