Medicare Supplement vs. Medicare Advantage

Which Plan is Right for Me?

One of the most important decisions you will make when enrolling in Medicare is deciding which type of Medicare coverage will work the best for you: Medicare Supplement or Medicare Advantage.

While both types of Medicare plans have their advantages and disadvantages, it is important to keep a few considerations in mind such as your needs and your budget, just to name a few. However, the first step is understanding the difference between Medicare Supplement and Medicare Advantage Plans.

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What is the difference between Medicare Supplement & Advantage?

Let’s start with the basics first. These questions below will help you decipher which plan is best for you, in simple & easy terms that you understand.

Do You Value Your Choice of Doctors, Specialist, and Hospitals?

Supplement Plans allow you to select your own doctors & hospitals nationwide, as long as they accept Medicare patients. Advantage Plans typically require you to use doctors & hospitals within your plans network, which can limit you to seeing your preferred doctor or specialist.

How Frequently Do You Visit The Doctor?

Advantage Plans often require copays and sometimes even deductibles. So for example, if you see your doctor twice a month and you have a copay of $40 per visit, that equates to $80 per month, which can add up quickly. However, if you do not see the doctor frequently, a Medicare Advantage could save you money. Supplement Plans do not require any out-of-pocket expenses such as copays. So if you visit your doctor often or plan on having any upcoming surgeries, this might be the better option for you.

Would You Rather Pay Out-of-Pocket Expenses or Have a Fixed Monthly Budget?

Advantage Plans will save you money on your monthly premiums, but you will have to pay out-of-pocket expenses when using your coverage or for any unforeseeable surgeries, hospital visits, etc. Versus Supplement Plans you have an allocated amount that you pay for your monthly premium that is a little higher than an Advantage Plan, however you do not have to worry about paying any out-of-pocket expenses when visiting your doctor, or worry about any unexpected trips to the hospital.

What Monthly Premium Can You Afford?

Medicare Supplement Plans can range from $85 – $150 per month, versus Medicare Advantage Plans that range anywhere from $0 – $60 per month. However, keep in mind that you will have to pay for Medicare Part B. That said, your overall monthly premium would still be lower with an Advantage Plan versus a Supplement Plan. Another factor to keep in mind with advantage plans is you will have more out-of-pocket expenses such as copays, for example.

Do You Travel Often or Plan on Traveling?

Supplement Plans allow you to see any doctor in the nation that accepts Medicare. So if you travel often and plan on visiting doctors in various states, a Supplement Plan would be a natural fit for you. If you do not travel often and only need to see doctors in your local network, an Advantage Plan might work just fine for you.

Check out our YouTube video on which type of plan is best for you: Medicare Supplement or Medicare Advantage Plans

One of the most important decisions you will make when enrolling in Medicare for the first time is selecting a Medicare Advantage or Medicare Supplement plan. While both types of coverage have both their advantages and disadvantages, it’s imperative that you select the plan that will work best for your needs and budget. Here is a helpful chart that we put together to help you weigh the pros and cons of both Supplement and Advantage plans side by side.

Medicare Supplement

Medicare Advantage

Monthly Premiums

$85 – $150

$0 – $60

Networks

No network restrictions. Coverage goes with you across the United States, and you can use any Doctor or Hospital that accepts Medicare.

You may have network restrictions, that can change every year. Be sure to check to that your doctor(s) are accepted by the plan you choose.

Out-of-Pocket Expenses

No co-pays, plan pays 100%.

You will be responsible for paying the deductibles, co-pays, and co-insurance (which can change yearly).

Referrals

No referrals are required. You are able to go to any specialist you choose that accepts Medicare.

Referrals to see specialist are typically required.

Coverage Area

Full coverage available nationwide. Ideal if you plan on traveling frequently once you retire.

Only emergency services are available outside local coverage area.

Enrollment

You can apply up to (6) months before you turn 65, and (3) months after you turn 65.

You can apply up to (3) months before you turn 65.

Prescription Drug Coverage

Prescription Drug Coverage (Part D) is not included. Most people elect to purchase a Part D plan in addition to their Supplement plan.

Many Advantage Plans include RX drug coverage.

Additional Benefits

Some plans include coverage while traveling outside of The United States.

Some plans include extra benefits such as vision, dental, vision and gym memberships.

Best Option If You Most Value

Your choice of doctors & hospitals and a predictable healthcare budget.

Low monthly premiums and do not mind using network doctors.

Watch The Video: Medicare Supplement vs Medicare Advantage

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