Medigap vs. Medicare Advantage: What’s the big deal?
Article published in Northampton Living
(July 2022)
Once enrolled in Original Medicare Parts A & B many people are faced with the confusing choice of whether or not to pick up either a Medicare Supplement, also known as a Medigap Plan, or a Medicare Advantage Plan.
Both Medigap and Medicare Advantage plans are fortification tools. We use either a Medigap plan paired with a stand-alone prescription drug plan (PDP) or a Medicare Advantage plan which most often includes prescription drug coverage to help fortify your health coverage and protect you from experiencing financial hardship due to unexpected medical bills.
Why the emphasis on drug coverage? Well, most people who are new to Medicare quickly discover that Original Medicare does not cover prescription drugs. Additionally, if you don’t enroll in a Part D (“D” stands for Drug) plan when you are eligible, you may face a penalty that follows you through your lifetime.
Original Medicare (your Red, White, and Blue card) alone does not provide coverage for Dental, Vision, and Hearing. Medigap plans do not provide coverage for these services either but quite often we will pair a Medigap plan with an additional stand-alone dental or vision plan to address the needs of members. Many Medicare Advantage plans add some level of coverage for these services. The descriptions I use most often to summarize these plan strategy options are as follows. You can ‘pay as you go’ with a Medicare Advantage plan; meaning there is an opportunity to save on the cost of your monthly premium but when you visit a doctor’s office or need a procedure you will pay a set copayment at the time of service. Or you can ‘pay a monthly premium up front’ with a Medigap plan to ensure that the plan takes care of your co-payments when these circumstances arise.
There is no one plan option that is a fit for everyone and unlike the employer-based coverage options many people are used to, there is no family plan available. The coverage decision should always be based on the needs and budget of each individual. For a married couple this may mean one spouse is enrolled in an Advantage plan while the other picks up a Medigap plan. The bottom line here is don’t worry. Take the headache out of the process by working with a professional such as myself who will help you sift through your options. Keep in mind that plan availability varies by county so skip the generic internet search that will lead you down rabbit holes of false information and anxiety. Medigap vs. Medicare Advantage: What’s the Big Deal? 413.376.4233 floralaffairsofgreenfield.com
Independent Medicare specialists do not work for the insurance carriers. Instead, we provide an independent, unbiased view of all insurance options available to seniors and Medicare recipients at no cost to the people we serve.
We specialize in: Medicare Advantage, Medigap, and Prescription Drug Plans. Our service to you doesn’t end when you enroll in a plan. We live in your community and are here to answer your questions on bills, drug plans, provider services, extra benefits and much, much more year-round.
Disclaimer: I do not work for and I am not affiliated with Medicare.