There are lots of sites out there that try to pinpoint the advantages and disadvantages of each type of Medicare companion.  However, if you are like me, an easy-to-read comparison chart can help enhance understanding.  Supplement Versus Advantage

I’ve included a brief chart that will highlight a lot of those differences, but it is not an all-inclusive list.  Why don’t you take a look and comment below as to what other areas you would like to see the two compared.

Medicare Supplement (MS)

Medicare Advantage (MA)

Premium/Out of Pocket

  • Monthly Premiums are generally higher, but some plans can be priced comparably to certain MA plans.
  • Co-payments are eliminated with some plans.  Some plans do feature co-payments, however.
  • Premiums are lower on the surface–Part B premium is still being paid (see government funding).
  • Rate increases are dependent upon the company itself.
  • Generally, a co-payment is due each time you are seen medically.

Deductible

  • “High Deductible” F plans for 2015 is $2,080 per year.
  • Part B is still working–meaning you pay any uncovered Part A or B deductible and 20% (exceptions are plans with cost sharing).
  • High deductibles can be up to $10,000 per year (or more if out of network).
  •  Deductibles work like group insurance.  You pay your entire deductible before benefits start (in most cases).

Relation to Original Medicare

  • MS plans go hand in hand with Original Medicare Benefits. See here for what Medicare Covers.
  • Can be structured to have little or no out-of-pocket when paired with Medicare Parts A and B.
  • Replaces Original Medicare–benefits are mirrored, but not exact.
  • Because it is outside of Original Medicare A and B, out-of-pocket costs are usually present.

Standardization

  • Standardized by letter–no matter what company presents the letter-though companies can offer new or innovative benefits to improve upon standardization (like preventative care riders).
  • Not standardized.  When purchasing plans, all aspects must be reviewed.

Network

  • No network.  Usable throughout the United States.
  • If facility does not accept Medicare’s assignment, patient is liable for excess charges (up to 15% above Medicare’s assignment if not covered by supplement-Plans F and G Cover this).
  • Network is specified by the company running the plan.
  • If not in network, higher deductible applies–sometimes up to 60% more for the same services OR 100% of the cost.

Government Funding

  • Completely Separate.  MS plans are funded completely by subscribers.
  • Government funding used to pay for your Part B premium, leaving the subscriber with sometimes $0 premium for the MA plan.  Funding has been disappearing more and more each year, so benefits, networks, and/or premiums are changed to fit that lack of funding.

Enrollment

  • Once you enroll, you don’t have to enroll again unless you want to change plans or companies for your supplement.
  • Medical qualification needed if changing outside of enrollment periods.
  • Open enrollment happens every year–you must make a decision as to which company/plan you want each time.
  • Changing companies and plans can occur each year, no medical qualification needed.

Other Benefits

  • Usually do not contain prescription coverage, so Part D (or other credible coverage) is needed.
  • MS may offer innovative or additional benefits–depends on the company (like preventative riders).
  • MA (MAPD) may offer prescription alongside, so Part D is included.  However some plans do not include prescriptions.
  • All additional benefits vary from company to company, including dental, vision, or wellness.

Travel?  Are you a “Snowbird?”

  • Usable in any State.   Since there is no network, you don’t have to worry about coverage.
  • Some MS plans offer foreign travel benefits.
  • Generally regional–travel has a high chance of being out of network.
  • No foreign travel benefits.

There you have it!  The final verdict?  Well, that is up to you.  Generally, if you don’t want to worry about deductibles and co-pays, a supplement may be better for you.  If you are more concerned with monthly premium size and/or having all your care with one company, a Medicare Advantage may work for you.

Please leave a comment below if more questions came up from this chart or if you have any feedback.  Stay tuned later on in the week when I will be exploring custodial care, home health care, and long term care.

About the author–

Medicare Supplement Versus Medicare Advantage--A Simple ChartRaphaelComparison ChartsMedicare SupplementsAdvantage,Part C,SupplementsThere are lots of sites out there that try to pinpoint the advantages and disadvantages of each type of Medicare companion.  However, if you are like me, an easy-to-read comparison chart can help enhance understanding.   I've included a brief chart that will highlight a lot of those differences, but...Making Senior Health Simple