Benefits of Medigap and Medicare Advantage Plans
While we often don’t like to think about the possibility of falling ill and needing treatment or hospitalization in the future, the fact is that we’re all susceptible to disease and illness. Health insurance can help ease the stress and financial burden of medical care, so it’s important to be sure you have a plan that’s suited to your lifestyle and needs.
What’s the Difference Between Medigap and Medicare Advantage?
Medicare plans tend to cover around 80% of approved hospital costs, i.e., basic health coverage. In comparison, the Medigap plans aim to fulfill parts A and B of the coverage gaps. To understand the various benefits of Medigap and Medicare, it might be helpful to understand what these terms actually mean.
Medicare Advantage is a type of private health insurance offered via Medicare. The insurance plans typically cover expenses for home health care, disability services, vision, dentistry, and other medical needs not covered by basic Medicare.
Medicare Advantage plans provide the convenience of receiving all of these services under one plan. These can be private fee-for-service (PFFS) plans; HMOs; PPOs; Special Needs Plans (SNPs); or Medical Savings Account (MSA) plans.
Your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage will be fully covered if you sign up for a Medicare Advantage Plan. Medicare prescription medicine coverage (Part D) is typically included in Medicare Advantage plans. You typically pay a single monthly payment for the plan’s medical and prescription medication coverage and your Part B cost.
Medigap, sometimes referred to as Medicare Supplement Insurance, supplements original Medicare by covering any coverage gaps. Typically, Medigap plans do not cover long-term care, at-home care, vision, or hearing.
They are helpful for particular coverage types, including routine emergency care or travel health insurance. Prescription drug coverage is not included in Medigap policies, and Medigap and Medicare Advantage cannot be combined. However, Medigap plans offer a method to customize your Medicare to your unique circumstances while providing coverage for higher costs.
Signing up for a Medigap plan might provide you with more comprehensive coverage and, more importantly, peace of mind because Medicare only covers roughly 80% of medical expenses. The remaining 20% will be taken care of by your Medigap plan.
Medigap is commercial insurance that complements Medicare (Part A and Part B) programs.
Benefits of Medicare Advantage Plans
More coverage and benefits include gym memberships, long-term care, and disability equipment. A comprehensive package deal that covers Medicare Parts A, B, and D.
Many Advantage plans provide low or no deductibles and no premiums. Another benefit of selecting Medicare Advantage is that most plans have caps on the highest out-of-pocket expenses you can incur in a given year.
Services Tailored to Your Needs
Medicare Advantage offers various plans depending on your unique circumstances; an SNP Advantage plan, for instance, can assist with your medical expenses if you suffer from a chronic medical condition. If you like provider independence, a PPO or PFFS plan may be your style. Many Medicare Advantage plans include additional dental, vision, or hearing treatments if you desire them.
Coordinated Medical Care
Coordinated medical care is a common feature of Medicare Advantage programs. Your healthcare providers must actively communicate to coordinate your treatment across various healthcare service types and medical specializations. This guarantees a medical team and helps you prevent idling costs and problems like medication interactions.
Things To Consider
While there are apparent advantages to enrolling in a Medicare Advantage Plan, there are some essential key points to consider before doing so. Being correctly informed is crucial for everyone in today’s world. So, here are a few essential need-to-knows about Medicare Advantage Plans!
- MA plans are yearly agreements. Plans may elect not to engage in contract negotiations or renewals.
- At the beginning of every new year, plans have the option to alter benefits, raise rates, and increase copayments.
- With a Medicare supplement plan, your annual out-of-pocket costs can be more than they would be under Original Medicare.
- Your current medical professionals may not participate in a plan’s network or may not consent to the payment terms.
- You often cannot maintain both the Medicare Advantage plan and your stand-alone Medicare Part D plan.
Benefits of Medigap Plans
Some of these may ring alarm bells for some of you, which is exactly why you should read about the next thing up for discussion—the Medigap plan.
Medigap plans can easily cover the shortcomings that come up with Medicare Advantage plans. Some key advantages are:
- Plans that provide additional coverage for Medicare can help with expenses like deductibles, coinsurance, and copayments.
- Some Medigap plans might essentially cover all of a person’s out-of-pocket expenses.
- If you sign up for insurance during the open enrollment period after turning 65, insurance providers cannot reject you based on pre-existing conditions.
- Your Medigap coverage will pay for 80% of your emergency medical care when you travel outside the US.
- There are numerous plan choices available to meet your unique healthcare needs.
Things to Consider
Medigap policies are supplemental insurance for original Medicare, with no additional coverage. While a Medigap policy can help cover some of your Medicare costs, it will not cover:
- prescription drugs
- vision, dental, or hearing care
- any other health perks, such as fitness memberships or transportation services
If you desire more Medicare coverage, you have many plan choices.
Medicare Advantage covers more than just Parts A, B, and D of your health insurance.
Medigap assists with out-of-pocket expenses like copays and coinsurance.
Because you cannot buy both of these programs, evaluating your demands and picking the plan that best satisfies those demands is crucial.
Everyone’s situation is unique and different from each other’s, so one insurance coverage plan cannot possibly work for all. This is precisely why the people at DeverCare put a lot of effort into working out which coverage plan will be right for you. Ranging from Medicare Supplements(Medigap), Medicare Advantage Plans (Part C), Prescription Drug Plans (Part D), Hospital Indemnity Insurance, Dental/Vision/Hearing Insurance, to Term/Final Expense/Whole Life Insurance, DeverCare Insurance has got you covered!
Whether answering inquiries or contacting the insurance company to check your claims and expenses, they will be available whenever you need them. With frequent check-ins throughout the year and during enrollment, DeverCare ensures that you are availing of the best services possible without any complaints or issues. Contact us for more details!