It is important to understand that Medicare Advantage is actually not part of Original Medicare. While most plans might be attractive thanks to a $0/mo. premium, you get what you pay for. It is important to look at what your exposure is which is most commonly in the form of copays found in your Evidence of Coverage book. Medicare Advantage plans are great until you have to use them, hence why many doctors call them “dis-advantage plans”. Most doctors prefer Medicare Supplements over Medicare Advantage plans for the simple reason that they pay better and they come with less red tape and bureaucracy. Medicare Advantage plans are steadily increasing in price or flat out dropping entire plans because of government subsidies being retracted. Many doctors, facilities and hospitals simply don’t accept Medicare Advantage plans while most of them take Medicare Assignment which means they take Medicare Supplements. All Medicare Advantage plans available for your state are listed in the back of the Medicare & You guide.

Supplements are letters from A-N with some missing in between. Supplements are intended to fill the gaps that Original Medicare leaves behind. Different supplements cover different things, and one of them covers EVERYTHING. That would be plan F. If you have a Medicare Supplement F you should never pay another medical for the rest of your life. Keep in mind prescriptions are completely independent from your healthcare costs with supplements. Unlike Medicare Advantage plans, supplements are guaranteed renewable meaning as long as you pay your premiums on time they can never be taken away from you. For example, the plan F is being discontinued in 2020 however anyone already on a plan F will be grandfathered for life. Below is a list of supplements and what they cover and a comparison of Medicare Advantage plans and Medicare Supplements.
supps

Medicare Advantage Medicare Supplements
Govt. Subsidized Yes No
Premium approx. $0-$100 approx. $40-$200
Networked Yes No
Referrals Needed Yes No
Portability County-Restricted No Restrictions
Drug Plan Included Yes No
Vision/Dental Included Certain Plans No
Copays Hospital (per day)
X-Rays
Labs
Specialist
Primary
Drugs
No
Maximum Out of Pocket approx. $3,000-$10,000 per year 0
Step Therapy Yes No
Medically Underwritten No Yes*

*Unless you are in a Guaranteed Issue period.

Leave a Reply

Your email address will not be published. Required fields are marked *

Post Navigation