Learn the difference between Medicare Medigap and Medicare Advantage Plans.
To understand the difference between a Medicare Medigap and Medicare Advantage Plan, first you need to understand what Medicare covers.
Medicare is a government sponsored and administered medical plan for people over 65 years of age and people with certain disabilities. It offers two parts, which are:
Part A helps with hospitalization. There are deductibles and copays, you can find these costs at Welch Insurance Medicare. Part A helps to pay for:
- In patient care in the hospital
- Semi-private rooms
- General nursing
- Drugs (including methadone to treat an opioid use disorder)
- Other hospital services and supplies as part of your inpatient treatment.
- Skilled nursing facility
- Hospice care
- Home Health Care
- Covers medication in hospital.
Part B helps pay for outpatient services:
- Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
- Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
Some things covered by Medicare Part B
- Clinical research
- Ambulance services
- Durable medical equipment (DME)
- Mental health
- Limited outpatient prescription drugs
Medigap is also called Medicare Supplement Plans
Medigap is also called Medicare Supplement Plans which are sold by independent insurance companies. These plans help cover the cost of Medicare Part A and Part B, however you do need to get a separate Part D drug plan. If you or your spouse has paid into Medicare through Social Security for 10 or more years you will not have a premium. There are typically 10 plans available in most states. Each plan is designated by a letter A through N. Each plan offered by a company with the same designated letter must give the same coverage, however, there can be as much as $100 a month premium difference between companies.
Medicare Advantage Plans Part C
Medicare Advantage Plans are sold by independent insurance companies. These plans can have a monthly premium as low as $0 in some areas. They replace the benefits of Medicare Part A and Part B with the company benefits. The benefits of an Advantage Plan are as follows;
- Medical coverage with a maximum out of pocket
- May include Part D drug plan
- May included additional benefits such as:
- Over the counter Items
- Fitness programs
- And more
There are six types of Medicare Advantage Plans.
HMO (Health Maintenance Organization)
PPO (Preferred Provider Organization)
PFFS (Private Fee For Service)
SNP (Special Needs Plans)
MSA (Medical Savings Account)
HMO-POS (HMO-Point of Service)
To learn more about Medicare join us at Medicare Education Events in Huntington Beach California. Get on-line quotes for 2023 at Medicare insurance Plans or you can set a no obligation phone appointment.
Deciding between a Medigap plan and a Medicare Advantage plan is an important decision, and one you should take the time to research. Medigap plans are standardized, regardless of the company, they must give the same coverage, but can have different monthly premiums. Medicare Advantage plans are private health insurance plans that give different coverage and have a network of providers you must stay in. You should think about your budget and your needs. Set a no obligation phone appointment to learn about your options.