What Are The Differences Between Medicare Advantage And Supplement Insurance Plans
The differences between Medicare Advantage and Supplement Insurance Plans are many and it's important to understand these differences in order to make a wise choice. They are different and mutually exclusive plans that require a decision. Supplemental coverage is gap insurance, while Advantage policies are private insurance coverage chosen instead of Medicare and Supplemental coverage.
Medicare, funded and managed by the federal government, is offered to anyone over 65, and to individuals with specified disabilities. Part A is coverage for hospital care. Part B assists with visits to doctors offices. Part C allows for Advantage (privatized) coverage, and Part D covers prescription drugs. Part D is government regulated but the coverage must be purchased separately. It's not an automatic benefit.
With supplemental coverage, the government pays for covered expenses, then supplemental insurance is billed for the remainder. Policies are tightly regulated by the government. Essentially it's a government written policy administered by a private company. Beneficiaries are offered a standard choice of plan options to choose from. Premiums are high and there's no add on benefits such as vision or dental. Part D drug coverage is not under this umbrella. It still has to be purchased separately.
Part C allows beneficiaries to elect for private coverage that can offer additional benefits such as vision and dental. Advantage plans maintain a contract with the government receiving payment for the taxpayer funded portion of coverage on a monthly basis. They charge plan members a premium based on the extra benefits they choose.
Most Part C policies offer coverage for prescription drugs, hearing, vision, and dental care, as well as preventive care options. Plan members pay a co-pay and coverage usually starts after a deductible, but premiums are less than those charged for supplemental policies, and additional benefits are available.
Part C policies have few exclusions. They're easy to qualify for. There is a specified enrollment period of 3 months before and after turning 65, or individuals can switch to Advantage coverage between 11/15 and 12/31 of every year. Most are HMO plans, but PPO's can be purchased also. Many private companies offer Part C coverage. They're private policies so premiums and benefit options can vary a lot. Do your research to find the best policy for your needs.
Supplemental plans are harder to qualify for. There are certain grace periods when they have to accept an applicant. When individuals first become eligible for Medicare they have 6 months to decide. If they choose supplemental coverage at this time they can't be turned away. Other exceptions provide for individuals to try out private insurance without penalty. If they cancel Part C coverage within 6 months they can enroll in supplemental coverage. An individual dissatisfied with supplemental coverage can switch to private coverage, and change their mind within 6 months, still being eligible for supplemental coverage. Outside these windows, applicants can apply for supplemental coverage all year round, but the medical underwriters do not have to approve the coverage. Beneficiaries can always cancel private policies to return to traditional Medicare with no exceptions.
It's important to understand the differences between Medicare Advantage and Supplement Insurance plans before making a decision. When you first become eligible you will receive a benefit guide from the government. The government also provides a website as a resource for general information with. Online sites allow you to compare benefits and premiums without pressure from a salesperson. Reading policy information can be a daunting task. Some individuals prefer to sit down with a trusted insurance agent to discuss the possibilities
The differences between Medicare Advantage and Supplement Insurance Plans are many and it's important to understand these differences in order to make a wise choice. They are different and mutually exclusive plans that require a decision. Supplemental coverage is gap insurance, while Advantage policies are private insurance coverage chosen instead of Medicare and Supplemental coverage.
Medicare, funded and managed by the federal government, is offered to anyone over 65, and to individuals with specified disabilities. Part A is coverage for hospital care. Part B assists with visits to doctors offices. Part C allows for Advantage (privatized) coverage, and Part D covers prescription drugs. Part D is government regulated but the coverage must be purchased separately. It's not an automatic benefit.
With supplemental coverage, the government pays for covered expenses, then supplemental insurance is billed for the remainder. Policies are tightly regulated by the government. Essentially it's a government written policy administered by a private company. Beneficiaries are offered a standard choice of plan options to choose from. Premiums are high and there's no add on benefits such as vision or dental. Part D drug coverage is not under this umbrella. It still has to be purchased separately.
Part C allows beneficiaries to elect for private coverage that can offer additional benefits such as vision and dental. Advantage plans maintain a contract with the government receiving payment for the taxpayer funded portion of coverage on a monthly basis. They charge plan members a premium based on the extra benefits they choose.
Most Part C policies offer coverage for prescription drugs, hearing, vision, and dental care, as well as preventive care options. Plan members pay a co-pay and coverage usually starts after a deductible, but premiums are less than those charged for supplemental policies, and additional benefits are available.
Part C policies have few exclusions. They're easy to qualify for. There is a specified enrollment period of 3 months before and after turning 65, or individuals can switch to Advantage coverage between 11/15 and 12/31 of every year. Most are HMO plans, but PPO's can be purchased also. Many private companies offer Part C coverage. They're private policies so premiums and benefit options can vary a lot. Do your research to find the best policy for your needs.
Supplemental plans are harder to qualify for. There are certain grace periods when they have to accept an applicant. When individuals first become eligible for Medicare they have 6 months to decide. If they choose supplemental coverage at this time they can't be turned away. Other exceptions provide for individuals to try out private insurance without penalty. If they cancel Part C coverage within 6 months they can enroll in supplemental coverage. An individual dissatisfied with supplemental coverage can switch to private coverage, and change their mind within 6 months, still being eligible for supplemental coverage. Outside these windows, applicants can apply for supplemental coverage all year round, but the medical underwriters do not have to approve the coverage. Beneficiaries can always cancel private policies to return to traditional Medicare with no exceptions.
It's important to understand the differences between Medicare Advantage and Supplement Insurance plans before making a decision. When you first become eligible you will receive a benefit guide from the government. The government also provides a website as a resource for general information with. Online sites allow you to compare benefits and premiums without pressure from a salesperson. Reading policy information can be a daunting task. Some individuals prefer to sit down with a trusted insurance agent to discuss the possibilities
About the Author:
It is very important to fully understand the benefits and costs of the Medicare Advantage or Medicare Supplement Plans that you choose. It is recommended that you consult with a licensed Insurance Agent to help guide you through the process.. This article, Discover The Difference Between Medicare Supplement And Advantage Insurance Plans has free reprint rights.
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