Since Medicare is embedded in the daily lives of nearly all American citizens over the age of 65, one might think it would be less confusing to navigate. The federal government program is so vast, however, that it remains pretty nuanced and hard to understand without a little help.
Aside from Original Medicare, which is comprised of Parts A and B, Medicare recipients have the opportunity to opt into programs that provide them with added benefits, such as Medicare Part D, which covers prescription drug costs, as well as Medicare Advantage and Medicare Supplemental Insurance (Medigap) plans. If you’re new to Medicare, or simply want to learn more about all of the options available to you, here are the main benefits to take into consideration when choosing additional coverage:
Medicare Advantage plans are private insurance plans that can be purchased to enhance the coverage you receive from Original Medicare. There are different types of Medicare Advantage plans, including HMO and PPO plans, which should be familiar to anyone who has ever had a private insurance plan. The plans that are available to you will vary based on your ZIP code and the different carriers, however, most Medicare Advantage plans include:
- No or low monthly premium payments, but higher copays.
- A maximum out-of-pocket spending limit.
- Added health coverage, such as vision, dental and hearing services (including the cost of hearing aids).
Additionally, some Medicare Advantage plans include benefits that you might not know about, such as:
- Telehealth services
- Gym membership or fitness subsidy
- Meal delivery
- Adult day care services
- Caregiver services
- Long-term care coverage
- Massage therapy
Brokers and licensed insurance agents are well equipped to guide you through the process in order to help you figure out which Medicare Advantage plan might be the best choice for you.
Like Medicare Advantage, Medigap policies were created to add upon the coverage you receive with Original Medicare. They are standardized plans designed by the federal government that aim to fill in the gaps that exist within Original Medicare coverage. Medigap plans are offered in partnership with private insurance companies, so their premiums and copays vary depending on your geographic location.
Medigap benefits vary, depending on which plan you opt into, but some of the little-known services that are fully supplemented with Medigap include:
- Hospice care
- Skilled nursing facility care
- Foreign travel emergency
One of the main draws with Medigap plans is that the insurance company cannot cancel your policy as long as you pay the premium, even if the state of your health might change. The policies are also renewable regardless of health status, which is another benefit of Medigap over Medicare Advantage plans, which require underwriting.
Medicare Advantage vs. Medigap: Which Is Better?
Medicare Advantage plans can be more expensive, but definitely include more amenities that wouldn’t otherwise be available to you with Original Medicare. Medigap plans, on the other hand, can be more cost-effective, especially if you have chronic health issues, but don’t offer as many additional benefits as Advantage plans.
Ultimately, it’s not really a question of which plan is better, but rather, which one is a better fit for your lifestyle, budget and needs. Learn more about the Medicare benefits that best suit your needs at myseniorhealthplan.com.