More than 10 million people had Medicare Advantage in 2010.
Medicare is a federal health plan meant primarily for senior citizens. Original or traditional Medicare comes in two parts called A and B, which have benefits for hospitalization, home health, hospice and preventive services. There are many medical services original Medicare does not cover, leading many people to look into supplemental insurance that will work with Medicare. Medicare Advantage is one kind of supplement, while Medigap plans range over 10 kinds of standardized policies as of 2010. Medicare Advantage and Medigap have some aspects in common, but also have several differences.
Types of Plans
Both Medicare Advantage and standard Medigap plans are obtained through private insurance companies rather than the government, although they must be approved by the Centers for Medicare and Medicaid Services. Medicare Advantage plans can be purchased as different kinds of plans, usually HMOs, PPOs, private fee-for-service plans, special needs plans and policies that work with a medical savings account. Medigap plans are usually just offered as fee-for-service plans, where members can go to any doctor they like but must submit all claims and paperwork themselves. Some states do offer their Medigap plans as Medicare Select, however, which allow regular Medigap plans to be sold as HMOs.
Prescription Drug Coverage
Prescription drug coverage is not included in original Medicare. If you need insurance to help pay for medications, you will need to seek an outside plan. However, after 2006, no Medigap policies offer prescription drug benefits, either. Medicare Advantage plans may offer it, although they are not generally required to do so. If you have a Medigap plan, you will also need to buy stand-alone Part D Medicare to cover your prescriptions.
Benefits
Medigap plans are standardized and are so are the same across the U.S., except when a waiver is issued to the state from the federal government. States may choose not to sell some of the plans, but the benefits for each plan remain unchanged. Since the benefits for Medigap do not depend on the insurance company, you can shop around for the best premiums and service. Medicare Advantage, however, can vary significantly. Medicare Advantage must include all the basic benefits provided by Medicare A and B, but after that, coverage, premiums and regulations are entirely up to the insurance company.
Costs
Medicare Advantage plans often require no monthly premium, while Medigap policies almost always do, unless you qualify for state assistance. Everyone who enrolls in the same Medicare Advantage plan pays the same premium, regardless of age, gender or health. Medigap policies often charge more the older you get and have different premiums depending on whether you are female or male. Medicare Advantage requires co-pays for service, while Medigap plans generally do not, except in the cases of Medigap plans K and L.
Tags: Medicare Advantage, Medigap plans, Advantage plans, Medicare Advantage plans, Medigap policies, while Medigap
