Medicare Supplement Insurance
Also called Medigap, these plans are offered by private insurance companies to cover the medical coinsurance (usually 20%) not covered by Original Medicare. These plans are health insurance only, no prescription coverage is included.
Original Medicare is Primary, so you need to carry your red, white, and blue Medicare card.
Insurance company is Secondary and pays AFTER Original Medicare.
Very limited out-of-pocket medical costs.
No networks – you can go to any doctor that accepts Original Medicare
Medicare Part D is not included and must be purchased separately.
Plans and benefits are identical between companies, but the rates can be A LOT different
You can’t be denied due to pre-existing conditions if you apply during your one-time Medigap open enrollment period.
If you already have a Medigap policy, you can change anytime during the year.
When to Enroll?
The best time to buy a Medigap policy is during your Medigap Open enrollment period. This 6 month period begins when you are 65 or older and enrolled in Part B for the first time. After this period, the insurance companies can underwrite your application and choose whether or not to accept you for coverage.
Medicare Advantage Plans
Medicare Advantage plans (Medicare Part C), are insurance plans offered by private insurance companies that have contracts with Medicare. When you enroll in a Medicare Advantage plan, you receive your Medicare Part A, Part B, and usually your Part D benefits directly from the insurance company. Medicare Advantage plans must cover everything that Original Medicare covers, but can add extra coverage like dental, vision, or a gym membership.
Insurance company is Primary and pays INSTEAD of Original Medicare.
No need to carry your red, white, and blue Medicare card.
You continue to pay your Medicare Part B premium.
Medicare Part D prescription insurance is included on many plans.
You will pay a copay for most medical services.
Higher costs if you see an out-of-network provider, with the exception of emergencies or urgent care.
Plans can differ between companies based on monthly premiums, copays, and provider networks.
You can’t be denied due to pre-existing conditions.
When to Enroll?
You must have Medicare Part A and Part B to be eligible. If you are new to Medicare, you can enroll in a Medicare Advantage plan during your Initial Enrollment period which is 3 months before you turn 65, during the month you turn 65, and up to 3 months after. Otherwise, you can enroll during the Annual Enrollment Period, which is October 15th – December 7th of each year.