Two common options for those over the age of 65 are Medicare Advantage plans and Original Medicare (Part A and B) plus a Medicare supplement plan (also known as Medigap).
While Medicare Advantage plans can offer some advantages, there are several reasons why sticking with Original Medicare and adding a supplement plan may be a better option for many seniors.
First, with Original Medicare and a Medicare supplement plan, you have more flexibility and choice.
Medicare Advantage plans are often HMOs or PPOs that limit your provider choices. With Original Medicare, you can choose any doctor or hospital that accepts Medicare nationwide. This can be particularly important if you live in a rural area. You need to see a specialist who is not in your network.
Second, Original Medicare and supplement plans generally offer more comprehensive coverage.
Medicare Advantage plans may offer extra benefits like dental, vision, or hearing coverage, but they often have limitations or exclusions. For example, a Medicare Advantage plan may only cover routine dental cleanings and exams. They may not pay for major procedures like root canals or crowns. A supplement plan, on the other hand, can help fill in the gaps in Original Medicare coverage. They will pay deductibles, copays, and coinsurance. This can provide more predictable out-of-pocket costs and better financial protection.
Third, Original Medicare and supplement plans are guaranteed renewable.
Once you enroll, your coverage cannot be cancelled or terminated due to health conditions. Medicare Advantage plans, on the other hand, are renewed annually and can change their benefit structure and network providers. This can be particularly concerning if you have a chronic condition or need ongoing care.
Fourth, Medicare supplement plans are standardized by the federal government.
This means that every plan with the same letter designation (such as Plan F or Plan G) provides the same basic benefits, regardless of the insurance company offering it. This makes it easier to compare plans and ensure you are getting the coverage you need at a competitive price.
Finally, with Original Medicare and a Medicare supplement plan, you have the option to enroll in a stand-alone prescription drug plan (Part D).
This provides an additional layer of coverage for prescription medications, which can be essential for those with chronic conditions or high drug costs.
Overall, while Medicare Advantage plans can be a good option for some seniors, they may not provide the same level of flexibility, coverage, and financial protection as Original Medicare and a supplement plan. By doing your research and weighing your options. You’ll then be able to make an informed decision about which type of coverage is best for your unique healthcare needs and budget.
By Joe DeAngelis
Medicare Supplement Advisory services