It depends upon your situation. Medigap plans are on average more expensive than Medicare Advantage plans. However, they tend to cover more costs that you may incur. It is important to discuss with your insurance broker your current situation. Your current health, financial situation, and the plans that are offered in your area all influence whether you should get a Medigap or Medicare Advantage policy.
Co-Founder, TermInsuranceBrokers.com, Goldenzweig Financial Group, Las Vegas, Nevada
Each type has it's pros and cons.
Medigap plans (commonly known as Medicare supplement plans) work with Original Medicare (Parts A & B) to fill the "gaps" that it doesn't cover. Original Medicare covers about 80% of your healthcare expenses. A Medigap plan can cover a portion or all of the other 20%, depending on which one you get. That's a BIG pro. You also aren't restricted to networks, you don't need referrals to see specialists, any doctor that accepts Medicare will accept the Medigap plan, you can apply for a different plan at any point throughout the year (if you want a different carrier or different benefits), and they are guaranteed renewable! The only con is that it typically costs more than an Advantage plan.
Advantage plans can be a lot cheaper, but have more restrictions and limitations than a Medigap plan does. The big attraction with them is the cost factor as the premiums are very cheap and some plans even feature a $0 premium - they can also include drug coverage (you have to buy a stand-alone part D prescription drug plan if you want prescription coverage when you have a Medigap plan). Some of the drawbacks are that you can have network restrictions, the plan coverage can change each year, your doctor can choose to no longer accept that specific plan, you're locked in to that plan for a year and can only change it during the annual enrollment period (Oct 15-Dec 7 of each year) or if you qualify for a special enrollment period.
Please note, regardless of which type of coverage, you must have both Part A & Part B and continue paying your Part B premiums (even though Advantage plans work in place of Original Medicare - Medigap plans work with Original Medicare).
Please let me know if I can be of further assistance. Thanks very much.
That is a great question! As Jason said, both plans have their positives, and negatives. The Medigap plans can cost more, but have better coverage. The Advantage plans are generally cheaper, but can change, and become a disadvantage. They are also the focus of cuts under the Affordable Care Act (Obamacare) designed to reduce overpayments and administrative costs. There were several large physicians organizations that grumbled about that, and they threatened to drop or cut back services. Whether they actually will, who knows. It might be safer to keep to Medigap. Thanks for asking!
For some people Medicare Advantage plans are an excellent senior health insurance solution. I believe at last count we were in the 13 to 14 million seniors participating in Medicare Advantage plans. As with most every choice in life there are tradeoffs involved. Medicare Advantage plans are essentially HMO plans for Medicare eligible seniors. They offer a broad, comprehensive range of benefits and value added services and wrap everything up in one package.
The flip side to Medicare Advantage plans is that their enrollees operate within the plan's contracted network of providers to receive their care. This does, by necessity, impose some restrictions on their member's choices in doctors, hospitals, pharmacies, etc., and this environment is not for everyone. That said, changes in the American health care system, some but not all prompted by ObamaCare, are also working in ways that make it more challenging for traditional Medicare enrollees to find and/or keep health care providers that accept Medicare. So, whichever way a senior citizen decides to go they will probably be faced with some difficult choices and compromises.
Medicare Advantage plans vary from one insurance carrier to another. One can't objectively say that Medicare Advantage plans are, as a class, a better or worse choice than traditional Medicare plans. That is a determination that each individual has to make for themselves based upon their perceptions of their present and future needs. Certainly Medicare Advantage plans are an option that a senior citizen should consider but the important thing is that people have a choice.
It depends on your specific situation and what you want out of your health insurance plan. I will give you some pros and cons to both.
Medicare Advantage-
1. The monthly premium is $0 per month or very low.
2. However, the max out of pocket per year can be as high as $6,700.
3. Has a network that changes all the time. You need to see doctors and hospitals within that network.
4. Has co-insurance, c0-pays and deductibles.
Medigap Plans- (also known as Medicare Supplement Plans)
1. Has a monthly premium. ( the amount will depend on which plan you choose)
2. The max out of pocket is $0 or very little. (some find it much easier to budget a monthly premium knowing they will never get stuck with a giant bill)
3. No Network- You can go to any doctor or hospital in any state you want. If they take Medicare they will take your Medigap Plan regardless of who the carrier is.
4. Has zero or very small co-pays, deductibles and co-insurance.
5. The benefits can never change with a Medigap Plan.
6. Medigap Plans are guaranteed renewable which means as long as you pay the monthly premium it can never be canceled on you.
You can visit our website for more information. I would be happy to answer any questions you have.
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Medigap plans (commonly known as Medicare supplement plans) work with Original Medicare (Parts A & B) to fill the "gaps" that it doesn't cover. Original Medicare covers about 80% of your healthcare expenses. A Medigap plan can cover a portion or all of the other 20%, depending on which one you get. That's a BIG pro. You also aren't restricted to networks, you don't need referrals to see specialists, any doctor that accepts Medicare will accept the Medigap plan, you can apply for a different plan at any point throughout the year (if you want a different carrier or different benefits), and they are guaranteed renewable! The only con is that it typically costs more than an Advantage plan.
Advantage plans can be a lot cheaper, but have more restrictions and limitations than a Medigap plan does. The big attraction with them is the cost factor as the premiums are very cheap and some plans even feature a $0 premium - they can also include drug coverage (you have to buy a stand-alone part D prescription drug plan if you want prescription coverage when you have a Medigap plan). Some of the drawbacks are that you can have network restrictions, the plan coverage can change each year, your doctor can choose to no longer accept that specific plan, you're locked in to that plan for a year and can only change it during the annual enrollment period (Oct 15-Dec 7 of each year) or if you qualify for a special enrollment period.
Please note, regardless of which type of coverage, you must have both Part A & Part B and continue paying your Part B premiums (even though Advantage plans work in place of Original Medicare - Medigap plans work with Original Medicare).
Please let me know if I can be of further assistance. Thanks very much.
The flip side to Medicare Advantage plans is that their enrollees operate within the plan's contracted network of providers to receive their care. This does, by necessity, impose some restrictions on their member's choices in doctors, hospitals, pharmacies, etc., and this environment is not for everyone. That said, changes in the American health care system, some but not all prompted by ObamaCare, are also working in ways that make it more challenging for traditional Medicare enrollees to find and/or keep health care providers that accept Medicare. So, whichever way a senior citizen decides to go they will probably be faced with some difficult choices and compromises.
Medicare Advantage plans vary from one insurance carrier to another. One can't objectively say that Medicare Advantage plans are, as a class, a better or worse choice than traditional Medicare plans. That is a determination that each individual has to make for themselves based upon their perceptions of their present and future needs. Certainly Medicare Advantage plans are an option that a senior citizen should consider but the important thing is that people have a choice.
Medicare Advantage-
1. The monthly premium is $0 per month or very low.
2. However, the max out of pocket per year can be as high as $6,700.
3. Has a network that changes all the time. You need to see doctors and hospitals within that network.
4. Has co-insurance, c0-pays and deductibles.
Medigap Plans- (also known as Medicare Supplement Plans)
1. Has a monthly premium. ( the amount will depend on which plan you choose)
2. The max out of pocket is $0 or very little. (some find it much easier to budget a monthly premium knowing they will never get stuck with a giant bill)
3. No Network- You can go to any doctor or hospital in any state you want. If they take Medicare they will take your Medigap Plan regardless of who the carrier is.
4. Has zero or very small co-pays, deductibles and co-insurance.
5. The benefits can never change with a Medigap Plan.
6. Medigap Plans are guaranteed renewable which means as long as you pay the monthly premium it can never be canceled on you.
You can visit our website for more information. I would be happy to answer any questions you have.