Hi everyone, Evan here — your insurance guru and all things Original Medicare. Okay, okay — I’m not a guru, but I do know a thing or two about health coverage, Original Medicare, how to compare Medigap Plans and this week I wanted to talk about a specific topic I get asked about fairly frequently Original Medicare, Medicare Advantage plans, Medicare Supplement Insurance, and more. In particular what are the difference between Florida Medigap vs Medicare Advantage.
There are many medicare advantage plans out there that cover prescription drugs, provide original medicare coverage and additional benefits, but which One Is Best, and what is the difference between a medigap plan?
Many of my clients who qualify for Original Medicare find themselves looking to fill in the gaps of their coverage with Medicare supplement insurance. However, it’s often frustrating navigating the insurance maze; which Medicare supplement insurance plan covers what you need? Which one provides additional benefits? Should you choose Medicare Advantage or fall into the group of Medigap insurers? Is there an open enrollment period? What’s the difference between a Medigap plan and a Medicare Advantage Plan? Which one (a medigap plan or a medicare supplement) will pay the most of your out of pocket expenses, provide Medicare part d prescription drug coverage or hospital insurance with the lowest monthly premium?
To answer one of the many questions, yes, there is a Medicare open enrollment period and insurance companies are all ready and waiting for you! If you’re looking at a medigap plan, those are also available.
Florida Medigap vs Medicare Advantage
There are two main options when looking into Medicare supplement plans or Medicare advantage plans for Medicare: Medigap Supplemental Insurance (Medigap plan) with a Standalone Part D Plan and Medicare Advantage (MA-PD). While MA-PD supplemental plans look inviting, with premiums as low as $0 or a “pay as you go”, there is a yearly maximum out-of pocket cost, plans can change from year to year, and you will have co-pays for hospital stay, tests, labs, x-rays, etc.
Unlike a Medigap plan, most Medicare Advantage plans have Medicare Part D plans embedded in them, meaning they come with part d prescription drug coverage, but they aren’t exactly tailored to your own health needs and you’d have to stay in network (if you have an HMO).
Essentially, Medicare Advantage Plans or Medicare Supplement plans may be a better option compared if you can’t afford a monthly premium and don’t have any specific medical issues needing attention.
Medigap plans, compared to a Medicare Advantage Plan or Medicare Supplement Plans, can also come with some very attractive features like no networks, low deductibles, and the freedom to access any provider that accepts Medicare. But which Medigap Insurance companies are best? Also unlike Medicare Advantage and where Medicare advantage differ, there are no referrals, no paperwork from one provider to the next for a Medigap plan. They offer predictable and comprehensive coverage.
Another major difference between a Medicare Advantage Plan and Medigap plans is Medigap plans don’t change year to year and there are no yearly maximum out of pocket costs for the health portion. Pretty good, right? Medigap plans are also guaranteed renewable — which means the insurance company cannot raise your rates on your Medigap plan or drop your coverage should any health conditions develop.
Your Medigap plan is perfect for those who travel frequently or embrace the “Snowbird” lifestyle. It’s also well suited for those who have serious health conditions or those who have a lot of medical usage. Based on these benefits, a Medigap plan sounds like the way to go, right? Still confused about what direction to go in between a medigap plan or Medicare Advantage Plan? Well let’s talk some more about Medicare Advantage.
Ready to Jump In?
Well, before you take the dive into Medigap coverage or Medigap plans, there are also some things to consider about Medicare Advantage:
One of the down sides of having such great coverage with a Medigap plan is that you’ll pay more for it than a Medicare Advantage Plan. Premiums are usually much higher than Medicare Advantage plans than a Medigap Plan because of its extensive coverage. Medigap plans also don’t come with drug coverage (Part D) like Medicare Advantage; they are purchased separately, called a “standalone Part D plan”. They go alongside your medical plan, and gives you an opportunity to best select your plan based on your medication needs. However, If you like the convenience of presenting only one card at your pharmacy, then Medicare Advantage plans may be best for you.
Every year Medicare raises the deductibles and co-pays for which you are responsible for or your Medicare approved amount (yippee). Your medical plan helps to pay for these things for you, and the cost of healthcare also experiences inflation like everything else, so it’s customary for Medigap plans to experience rate increases from year to year.
With most carriers, this rate will occur once a year on your policy anniversary, and depending on when it happens is where I come in or one of our expert agents. We will comparison shop your policy between Medigap plans as well as Medicare supplement plans to see if other carriers offer other Medigap plans for less.
We’re Here For You
Take a deep breath — I know this is a lot of information about your Medigap plan, Medicare Supplement plans, whether Original Medicare is all you need or what your medigap plans cover. And a lot to consider when choosing Medicare Supplement Plans and what’s best for your health. But don’t worry, that’s what we’re here for! We work with Medicaid services and private insurance companies to ensure your Medigap plans and Medigap policies cover, whether it be prescription drugs or other services. We help you find which doctor accepts Medicare.
We compare medigap plans, determine your medicare supplement plan approved amount, figure out your monthly premium, and help determine which medicaid services or medigap policies apply best to you. If you would like any advice on your Original medicare plan, Medicare beneficiaries, Medicare supplement plan, or simply your medigap policy, we are here to help! It’s important to understand your medigap policy, your Medicare beneficiaries, and what your Medicare advantage covers.
Medicare advantage plans or Medicare supplement plan provide supplemental medicare coverage, help with out of pocket costs as well as out of pocket expenses and medicare benefits. Buy calling and speaking to one of our expert agents about medical insurance, what medicare advantage plans offer, what your plan covers, and what medicare pays, you’ll be more knowledgable than ever.
If you have a year or less before you become a medicare enrollee, that’s okay! You can contact us about any questions regarding your Original Medicare policy, your Medicare Supplement plan, your Medigap plan, your prescription drugs coverage, any medical underwriting that is taking place, or even if you’re a business with medicare enrollees approaching.
Let us help you figure out exactly what you need. Do you have questions? Feel free to send me a message regarding your Medicare Supplement and I’ll be happy to help you. It’s important to speak with a licensed insurance agent or broker like us! We can be reached anytime at 954-282-6891.