Medicare Advantage plans replace Original Medicare (Part A and Part B). When you buy a Medicare Advantage plan, the insurance company provides all your health coverage, not Medicare. Most Medicare Advantage plans include extra benefits for routine vision and dental care. Nearly all include Part D prescription drug coverage. In exchange for these additional benefits, you have to follow your plan’s rules. These guidelines often include using only approved network providers and getting prior authorization for specific tests and procedures.
Medicare Supplement plans complement Original Medicare. These plans cover most of your out-of-pocket costs with Part A and Part B. You still get your health insurance from Medicare, but your Medicare Supplement plan pays your deductible and coinsurance. You usually don’t get any extra benefits with Medicare Supplement plans. If Medicare doesn’t cover a service, neither will your Medicare Supplement plan. Some plans do offer stand-alone vision and dental plans for an extra monthly premium. A few plans even include extra benefits at no additional cost.
Medicare Supplement plans don’t pay your out-of-pocket costs with Part D. If you buy a Part D plan, you’re responsible for the deductible and coinsurance. Medicare Supplement plans don’t have restrictions such as provider networks and prior authorization. You can use your plan with any provider that accepts Medicare.
What are the costs of Medicare Advantage vs. Medicare Supplement plans?
No matter what type of Medicare plan you choose you still have to pay your Part B premium. If you’re one of the few people who pay for Part A, you’ll have to continue paying that premium as well.
Premiums
You pay a separate monthly premium for Medicare Supplement plans. The cost of your premium depends on the plan you choose, your age, location, sex, and other factors. Premiums typically range between $50 and $250 a month and often increase the price as you get older.
Some Medicare Advantage plans have a monthly premium, but most people choose a $0 premium plan. Among those who pay a premium, the average cost is $25 a month, which usually includes Part D coverage.
Deductibles
You don’t have an annual deductible with Medicare Supplement plans unless you choose a high-deductible plan. Most Medicare Supplement plans pay your Part A deductible, coinsurance, and 100% of your Part B costs after meeting the Part B deductible.
If you choose a high-deductible plan, your plan pays 100% of your costs after you pay $2,340 out-of-pocket.
Medicare Advantage plans may or may not have an annual deductible, but most people have access to a $0 deductible plan. Some plans have a separate deductible for Part D.
Cost-sharing
There is no cost-sharing with most Medicare Supplement plans. This means the plans pay 100% of your Part A inpatient and Part B coinsurance. If you choose Plan N, you pay a small copayment at the time of service. The copay is usually $20 or less for doctor visits and $50 or less for emergency room care.
You usually pay a flat copayment for health care with Medicare Advantage plans. A typical HMO plan might charge $5 for primary care visits, $25 for specialist care, and $50 for urgent care and emergency room visits.
Cosmo Insurance Agency is a full-service independent insurance agency based in Hackensack (Bergen County) and Lakewood (Ocean County), New Jersey that offers an all-encompassing range of insurance options for both individuals and businesses. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating our knowledge of the insurance guidelines for healthcare, employee benefits, life insurance, self-insurance, dental, disability, and long term care insurance, we keep our clients up-to-date with affordable plans that cover all their specific insurance needs.
