- Lesson 11:13
- Lesson 21:32
- Lesson 36:23
- Lesson 43:24
- Lesson 56:57
- Lesson 64:05
- Lesson 72:19
- Lesson 80:45
Medicare Advantage vs. Medicare Supplement
Now that we’ve covered some of the basics and costs of Medicare Advantage plans, how do they compare with other Medicare coverage?
We’ll look at a few factors like cost, access to care, and enrollment opportunities to compare Medicare Advantage and Medicare Supplements. Let’s start with costs.
Medicare Advantage plans often offer low to zero-dollar premiums compared to the higher premiums of Medicare Supplements. The trade-off is that Medicare Advantage plans have additional out-of-pocket exposure, while Medicare Supplements usually reduces or eliminates those cost-sharing expenses for the beneficiary.
Medicare Advantage plans can be a great fit for clients who’d prefer to keep monthly costs down and are in good health. What about accessibility to providers? If you recall from our lesson on Medicare basics, many Medicare Advantage plans work with a network of providers. In certain plans, the beneficiaries may only use those providers.
Compare this with a Medicare Supplement, which gives the beneficiary the same access to providers as Original Medicare.
From the MA network standpoint, clients who stay close to home and live in urban areas with more providers typically make ideal clients for a Medicare Advantage plan. Also keep in mind that some plans, like PPOs and MSA plans, offer a degree of flexibility in their networks. So, even if your client is a snowbird, that doesn’t necessarily count Medicare Advantage plans out of the running.
Next, let’s compare some of the extra benefits.
Medicare Advantage plans often cover extra services like prescription drugs, fitness memberships, over-the-counter allowances, and more!
Medicare Supplements can also offer some benefits like fitness membership, but they usually offer less extra benefits than Medicare Advantage plans.
If you’re working with a client that prefers being with one carrier for all of their coverage needs or could benefit from some of the extra perks, then a Medicare Advantage plan could work well for them.
Lastly, let’s take a look at enrollment opportunities.
There are many enrollment opportunities in Medicare Advantage plans, including an opportunity to make a change each year. However, beneficiaries need to have an eligible enrollment opportunity to enroll, disenroll, or switch their Medicare Advantage plan. Medicare Supplements do offer the flexibility to enroll at any time, but clients must complete health underwriting questions and can be denied coverage.
You might be asking, “but what about Original Medicare?”
While you can find more comparisons at Medicare.gov, we want to give you a quick overview here. And don’t worry, we’ll link to that information in the resources for this Module!
Since Medicare Advantage plans must cover all services that Original Medicare covers, and offer added benefits and a set maximum-out-of-pocket amount, your clients will often benefit by joining a Medicare Advantage plan instead of staying with Original Medicare.
There is usually limited access to providers as we have discussed, so it’s important to consider if additional coverage outweighs network restrictions. Hopefully now that we’ve walked through these comparisons, it shows that there is no one-size fits all solution.
Take time to listen to your clients, evaluate their needs and concerns, and make a recommendation based on the information they’ve provided. Doing so allows you to place your client in a plan that’s a good fit for their needs. It will also go a long way towards establishing trust and building your relationship.