By Cascadia Insurance LLC
A, B, C, D and supplements… Someone under 65 might confuse this for a list of essential vitamins and minerals, but it actually
represents the major parts of Medicare.
Many folks think they understand the basics of these parts so we will skip to the first common dilemma Medicare recipients face
Part C (“Medicare Advantage Plans”) and Medicare Supplements offer two contrasting choices for health insurance. Thus begins one of the complications that Medicare recipients face: “What’s the difference, and which one is better?” Medicare recipients ask us this often.
Basically, a supplement is secondary to Medicare, and it therefore “supplements” or fills in the gaps of Parts A and B (A.K.A. “Medigap policies”). To add to Medicare’s alphabet soup, each supplement is identified by letters A through N. Benefits of each are identical among every company so only premiums and service varies.
An advantage plan, also offered by a private company, replaces original Medicare A and B while you are enrolled and becomes your primary coverage. So, which should you choose? For those who can afford either it is an especially difficult choice.
The first question is often price. No one should pay more than around $205-210 for a Supplement “F,” which provides comprehensive coverage. Adding stand-alone prescription coverage typically adds an extra $18-$35. Compare this to advantage plans which usually include prescription coverage and you may experience sticker shock when you see premiums under $50 monthly. However, it really is comparing apples to oranges so clients rarely decide based on price. In fact, despite the lower premiums, only about 30 percent of those in Whatcom County chose advantage plans in 2015, according to cms.gov. So here are other considerations for both:
Supplements: As stated above, cost is typically higher. The good news is you can have zero out-of-pocket expense – imagine paying nothing for doctors or major hospitalizations! They also offer access to any doctor nationwide who accepts original Medicare; the ability to keep your policy if you move and lifelong stability because the policy never changes. Note, however, a few medical facilities in counties south of us will not accept original Medicare or supplements.
Medicare Advantage plans: Many choose these simply because of low or nonexistent premium. They are defined by a copay structure that make them equivalent to “pay-as-you-go.” In addition to low premiums, folks are commonly attracted by the additional benefits that may be offered such as: eyewear, dental and even hearing aids. The potential disadvantage is that they usually require participation in an HMO or PPO network.