Is medicare advantage the same as medicare supplement

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Is medicare advantage the same as medicare supplement

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Learn the difference between Medicare Advantage and Medigap to find the best plan for your health care needs.

If Medicare won’t cover all your healthcare needs, Medicare Advantage and Medigap can help. Both Medicare Advantage and Medigap supplement original Medicare to provide more coverage, but there are some important differences between the two.

What is Medicare Advantage?

Medicare Advantage is private health insurance through Medicare that often also includes prescription drug coverage, or Medicare Part D. The plans usually provide coverage for things like vision, dental, disability services, home health, and other health care needs not covered by original Medicare.

“Medicare Advantage plans offer the convenience of providing all of these services in one plan,” Erin Nance, MD, a New York City-based orthopedic surgeon, tells WebMD Connect to Care. “The costs and coverage details vary depending on the specific insurance company and what state you live in.”

Medicare Advantage plans can be HMOs, PPOs, Special Needs Plans (SNPs), private fee-for-service (PFFS) plans, or Medical Savings Account (MSA) plans.

While Medicare Advantage patients don’t need referrals to see a specialist, there are some limits when it comes to providers.

“There are different types of Medicare Advantage Plans that may limit your ability to see a certain provider,” Nance says. “The vast majority of doctors accept Original Medicare and the Medigap supplemental insurance.”

What is Medigap?

Medigap, also known as Medicare Supplement Insurance, adds to original Medicare by filling in gaps where you aren’t covered. Medigap plans usually don’t cover vision, hearing, long-term care or at-home care. However, they're useful for specific types of coverage, such as health insurance while traveling or frequent emergency care.

For instance, under Medigap plan N, foreign emergencies and hospital visits are covered, while emergency visits cost $50. Medigap plan F, a more expensive plan, pays for Part B deductibles while covering the 20% cost of services Medicare doesn’t pay.

Medigap plans do not provide prescription drug coverage, and Medigap cannot be combined with Medicare Advantage. But Medigap plans are a way to tweak your Medicare to your specific situation while covering larger expenses.

Which one is better?

Both Medicare Advantage and Medigap provide advantages and disadvantages.

Some advantages of Medicare Advantage include:

  • More coverage and benefits, which can include services like gym memberships, long-term care, and disability equipment
  • Lower premiums
  • An all-in-one plan which covers Medicare Part A, B, and D 

Some disadvantages of Medicare Advantage include:

  • Having to make sure your preferred provider is in your plan
  • No coverage while traveling
  • A likelihood of higher out-of-pocket and emergency costs

Some advantages of Medigap plans include:

  • Fewer out-of-pocket expenses
  • Access to all providers who accept Medicare
  • Coverage while traveling overseas

Some disadvantages of Medigap plans include:

  • Higher monthly premiums
  • Having to navigate the different types of plans
  • No prescription coverage (which you can purchase through Plan D)

How do you decide?

“Make sure you have enough coverage to limit your financial liability in case of catastrophic injuries or disease,” Nance says. “While the plans that have better benefits often cost more, they will usually save you in the long run in terms of out-of-pocket fees.” Nance further recommends speaking to family and friends to compare experiences.

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  4. Compare Medicare Advantage vs. Medicare Supplement Plans

Medicare Advantage plans

Medicare Advantage plans offer additional features and benefits – beyond Medicare Parts A and B (Original Medicare). Most UnitedHealthcare Medicare Advantage plans include*:

  • $0 copays on most common prescriptions**
  • $0 copays for primary care visits
  • Vision and dental coverage
  • Fitness programs

Medicare Supplement Insurance plans

Since Medicare doesn’t pay for everything, Medicare Supplement plans are designed to help cover out-of-pocket expenses. Also known as “Medigap,” these plans complement your existing Original Medicare coverage.

Depending on the plan you choose, you may receive coverage for many out-of-pocket expenses that Part A (hospital) and Part B (doctor) don’t cover, such as: 

  • Deductibles
  • Coinsurance
  • Copayments (copays)

Shop plans in your area

See the Medicare Advantage and Medicare Supplement plans available where you live.

Comparing Medicare Advantage and Medicare Supplement plans

Here are some of the key items people like to compare when deciding between a Medicare Advantage plan and a Medigap plan. 

Medicare Advantage plans Medigap plans
Doctors and hospitals

You may be required to use doctors and hospitals in the plan network.

You can select your own doctors and hospitals that accept Medicare patients.

Referrals

You may need referrals and may be required to use network specialists, depending on the plan.

You can see specialists without referrals. 

Coverage when you travel

Non-emergency care might depend on your plan’s service area. Emergency care is generally covered for travel within the United States and sometimes abroad.

Coverage goes with you when you travel across the United States and, depending on the plan, may cover emergency care when traveling abroad.

Enrollment

Generally, there are specific periods during the year when you can enroll in or switch to a different Medicare Advantage plan. And you generally can’t be denied coverage or charged more based on your health status.

You can apply to buy a plan any time after you turn 65. However, if you apply during your Open Enrollment Period, you are guaranteed coverage at the best available rate for you, regardless of your health status.

Costs

Generally, you pay a low or $0 monthly plan premium (in addition to your Part B premium). When you use services, you pay copays, coinsurance, and deductibles up to a set out-of-pocket limit.

For Medicare-approved doctor and hospital services, you’ll pay a monthly plan premium in addition to your Part B premium. When you use services, you’ll have
low—or no—copays and coinsurance, depending on the plan selected. 

Prescription drug coverage

Prescription drug coverage is included with most plans.

Prescription drug coverage is not included. Consider buying a standalone Part D plan for more complete coverage. 

Medicare Advantage and Medicare Supplement Plan information and tools

UnitedHealthcare provides information and tools to make it easier to find the plan you need, and learn as much as possible before you choose.

View plans and pricing

Find Medicare Advantage and Medicare Supplement plans in your area.

Shop plans

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Make an appointment with a licensed insurance agent/producer in your area

*Benefits and features vary by plan/area. Limitations and exclusions apply.

** These benefits are not available with all plans and may vary by plan. The “most common prescriptions” refers to Tier 1 and 2 drugs filled through a preferred mail order pharmacy.

What is the biggest disadvantage of Medicare Advantage?

The biggest disadvantage of Medicare Advantage plans is the closed provider networks, limiting your choice of which doctor or medical facility to use. Medicare Advantage costs are also largely based on how much medical care you need, making it more difficult to budget for health care costs.

Can I switch from a Medicare Supplement to an Advantage plan?

You can make the switch from Medigap to Medicare Advantage. In many cases, Medicare Advantage can be a better choice and provide the best mix of coverage, so it could be a good idea to make the switch.

Can I have both Medicare Advantage and supplement?

While you can't add a Medicare Supplement plan to a Medicare Advantage plan, the added benefits MA plans provide help make up the difference when it comes to out-of-pocket costs. One great feature is the security of an annual limit on out-of-pocket costs, after which you pay nothing for covered services.

What is another name for Medicare Advantage?

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. Medicare pays these companies to cover your Medicare benefits.