Medicare Advantage plans vs. Medicare Supplement plans

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Knowledge can help you make the right choice

Everence® members sometimes ask us about Medicare Advantage plans. What are they? How do they work? Are they different than a Medicare Supplement plan?

Let’s outline differences between Medicare Advantage plans and Medicare Supplement plans.

1. Network of doctors and hospitals
Medicare Advantage plans have a regional network of doctors and hospitals. You can go to another doctor, but the best pricing is within the network.
Medicare Supplement plans have a national network of doctors and hospitals. It’s easier to travel or to have a specialist in another area.

2. Premium costs
Medicare Advantage plans usually are inexpensive because they offer less coverage than a Medicare Supplement plan. Whatever you choose, you should continue paying your Medicare Part B premium.

3. Coverage
A Medicare Advantage plan takes the place of Medicare Parts A and B. Sometimes, an Advantage plan will add coverage – like vision or dental – but they aren’t allowed to add a Medicare Supplement plan.
A Medicare Supplement plan is in addition to the coverage offered by Medicare Parts A and B.

4. Stability
Medicare Advantage plans often change their benefits/networks/premiums in January, so it’s important to read all documents sent near the end of the year.
Medicare Supplement plans are regulated, and the basic structure doesn’t change. Plans cannot be canceled as long as premiums are paid.

5. Claims
With a Medicare Advantage plan, claims decisions are made by the insurance company you have chosen.
With a Medicare Supplement plan, claims flow through the Medicare system first and then go to the Supplement insurance company. 

Everence
Author Everence Staff

Questions to ask

Are you willing to take some of the risk of medical expenses yourself (Medicare Advantage)? Or are you more comfortable transferring that risk to an insurance company (Medicare Supplement)? Everence can help you chart your course.

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