When it comes to choosing a health care plan, each person’s needs are unique. To better understand the different features of Medicare Advantage vs. Medicare Supplement, here is a short guide.
Medicare Advantage
Medicare Part C, also called Medicare Advantage, is a health plan that provides your Part A (hospital insurance) and Part B (medical insurance) benefits through private insurance companies. These companies contract with the federal Medicare program, so while you are still enrolled in Parts A and B, you receive the benefits through the insurance company rather than through Original Medicare.
Medicare Advantage plans usually offer low or $0 premiums and may provide benefits beyond Original Medicare, such as dental, vision, hearing and fitness benefits. Many include prescription drug benefits as well.
Medicare Supplement
Like Medicare Advantage, Medicare Supplement plans (also known as Medigap) are offered by private insurance companies. With these plans, you will receive Parts A and B benefits through Original Medicare. Medicare Supplement plans then pay for some of the out-of-pocket health care costs that are not covered by Original Medicare, such as Parts A and B deductibles and copayments.
Medicare Advantage and Medicare Supplement also differ in terms of where you can access care. With Medicare Supplement, you have freedom of choice. Since you still receive your Part A and Part B benefits through Original Medicare, Medicare Supplement plans are accepted by any provider that accepts Original Medicare.
Medicare Advantage plans generally have networks of participating doctors and hospitals, where members can receive full benefits for covered services. Depending on the type of Medicare Advantage plan, you may still have coverage, such as emergency care or urgent care services, outside of that network.
When to enroll
Your ability to move to a different plan is another difference between Medicare Advantage and Medicare Supplement. With Medicare Advantage plans, there is an Annual Enrollment Period (AEP) every year from Oct. 15 through Dec. 7, when you can elect new coverage regardless of health.
With Medicare Supplement, you have an initial six-month enrollment period when you will not have to go through medical underwriting (answer health questions) to be eligible for your plan. However, any time after your initial enrollment period, you can change plans throughout the year, as long as you are healthy enough to pass underwriting.
Each fall, Medicare Advantage and Prescription Drug Plans have an AEP during which you can change plans. For more information, visit Medicare.gov. Additional information about Blue Cross and Blue Shield of Nebraska Medicare coverage options can be found at Medicare.NebraskaBlue.com.
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