Difference Between Medicare Supplement Plan & Medicare Advantage Plan | Senior Enrollment Solutions


– Hi, I’m John Fallot with
Senior Enrollment Solutions. Today, we’re going to discuss
how to fill in the gaps of your original Medicare. Understand that
your Medicare Part A has a per occurrence deductible and then you’re
responsible for 20% of any and all
remaining charges. Your Part B: an
annual deductible, and you’re responsible for 20% of any and all
remaining charges. So, you have two
options in filling in what the government is
unable, or unwilling, to provide to you. Your first option is to purchase a Medicare supplemental plan, oftentimes referred to
as a Medigap policy. The pros of this: you can go to any doctor,
you can visit any facility, any hospital nationwide, and you’re covered
at, or near, 100%. The negatives: there is a premium in purchasing a Medicare
supplemental plan. Understand that they
are all standardized, providing exactly
the same coverage. The only difference to you is the monthly premium
that you’re paying and the ratings of
the insurance carrier. To run your rates,
you can always visit the
SeniorEnrollmentSolutions.com
website. In regards to supplemental
plans, another negative, if you will, is that you would
have a stand-alone
prescription drug plan. You would have health
coverage through carrier A, and prescription coverage, most often times,
through carrier B. Your other option in filling
in what Medicare is unwilling to cover for you, is to purchase
a Medicare Advantage plan. With a Medicare Advantage plan, you’re assigning your coverage to a private insurance carrier. And, in turn, the government
is no longer covering, if you will, your part A
and part B of your Medicare. They’re giving it to a
more effective carrier to process your claims and
your billing, et cetera. So, in turn, the government
then reimburses this private insurance carrier
a lump sum of money to provide you
coverage that’s either, as good as or better than, your original
Medicare Part A and B. So, the pros: with a Medicare Advantage plan, oftentimes there is
no monthly premium, or a very low monthly premium because it’s, once again,
subsidized by the government. Another positive is that
they include the luxuries of Medicare. Your dental, vision, hearing, prescriptions, transportation, over-the-counter medications,
would all be included on a Medicare Advantage plan. With a Medicare Advantage
plan, understand that they’re just like health insurance,
where you’ll be limited to an HMO or a PPO network. You have to say within
that carrier’s network, or if you leave
you’ll be penalized, or won’t have coverage. And, just like health insurance,
they all have copayments, they all have deductibles,
and they all have a risk set by the federal
government not to exceed $6,700 a year in out-of-pocket consumer cost. So, understand your
two differences. With a Medicare
supplemental plan: any doctor, any hospital,
no referral requirements, near or at 100% coverage. However, you’re paying a
premium to have that coverage and you’re purchasing
prescription drug
coverage elsewhere. With a Medicare Advantage
plan: no monthly premium, you get the luxuries,
if you will, of what Medicare doesn’t offer, dental, vision, hearing,
transportation, et cetera. However, you’re going to be
bound to a network of doctors, paying copayments and
deductibles along the way, possibly going up to a
$6,700 potential risk. Once you make this decision, purchasing coverage is simple. If you have any other questions, visit us at
SeniorEnrollmentSolutions.com, or phone us at 877-777-5972.

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