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Ashford Insurance

Navigating Between Medicare Supplements and Medicare Advantage

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Sarah Fuhrmann

Sarah Fuhrmann is an agent of Ashford Insurance an independent health insurance agency specializing in Texas Medicare insurance.

In our ongoing commitment to empower consumers with essential knowledge, Ashford Insurance has compiled detailed information to aid in the decision-making process between Medicare Supplement (Medigap) and Medicare Advantage health care plans.

Navigating Between Medicare Supplements and Medicare Advantage


In our ongoing commitment to empower consumers with essential knowledge, Ashford Insurance has compiled detailed information to aid in the decision-making process between Medicare Supplement (Medigap) and Medicare Advantage healthcare plans.

Cost Considerations

Medicare Supplement plans offer the flexibility of being accepted by any provider or facility that accepts Medicare, without network restrictions. This ensures you have the freedom to choose your healthcare providers nationwide. While monthly premiums for Medicare Supplement plans may be higher compared to Medicare Advantage plans, they often come with the benefit of an annual limit on out-of-pocket costs.

On the other hand, Medicare Advantage plans typically involve co-payments or co-insurance for covered services, along with a monthly premium. These plans operate within a limited network of providers, which may restrict your choices. While Medicare Advantage plans may offer low or zero-dollar premiums, the out-of-pocket costs when receiving care can be higher compared to Medicare Supplement plans.

Network Accessibility

Original Medicare and Medicare Supplement plans allow you to choose any Medicare-approved providers nationwide, providing flexibility and continuity of care. This means you can continue treatment with your preferred physician or facility, even during specialized treatments like cancer care.

In contrast, Medicare Advantage plans require the use of in-network providers and facilities, potentially limiting your options. Seeing a specialist outside of your plan’s network could result in significant out-of-pocket expenses.

Convenience and Benefits

Medicare Advantage plans often include prescription drug coverage, which is not offered by Medicare Supplement plans. However, it’s crucial to ensure that your preferred doctors and hospitals are contracted with the Medicare Advantage plan to avoid inconveniences when accessing routine care.

For travelers and those seeking nationwide coverage, Medicare Supplement plans are advantageous as they provide consistent access to care across the country, where original Medicare is accepted.

Extra Benefits

Some Medicare Advantage plans may offer additional benefits like coverage for hearing aids, dental care, vision care, and gym memberships. While these “extra” benefits can be appealing, it’s essential to evaluate their true value against your healthcare needs in case of illness or injury.

Choosing the Right Plan

Deciding between Medicare Supplement and Medicare Advantage plans depends on individual preferences and needs:

  • Medicare Supplement plans may be suitable for those who prefer freedom in choosing healthcare providers, seek assistance with copayments and Medicare costs, and prefer a consistent monthly premium.
  • Medicare Advantage plans with prescription coverage may be ideal for individuals seeking comprehensive coverage under one premium, residing in areas with good in-network provider choices, and capable of absorbing out-of-pocket costs.

Individualized Decision-Making

Every person’s healthcare needs are unique. It’s advisable to explore resources like Medicare 101 training and counseling provided by Ashford Insurance.

Important Considerations

It’s important to note that there are regulations governing the ability to switch between Medicare Advantage and Medicare Supplement plans. Understanding these rules can help you make confident and well-informed choices for your healthcare coverage.

For further guidance and assistance in navigating Medicare options, feel free to reach out to our knowledgeable team. We are here to support you in choosing the plan that best aligns with your healthcare needs and preferences.

 

 

Photo by RDNE Stock project

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Picture of Sarah Fuhrmann

Sarah Fuhrmann

Sarah Fuhrmann has been helping Medicare eligibles in Texas with their Medicare Insurance since 2018.