Comparison Between Medicare Supplement Plan and Medicare Advantage

Introduction

Medicare Supplement Plans and Medicare Advantage plans are offered by private insurance companies and they complement the Original Medicare. The Original Medicare does not meet all the expenses of healthcare for meeting which the customers have to purchase the Medigap policies or the Medicare Advantage plans. The salient differences between the two are provided below:

 

Standardized Plans

The Medigap plans are standardized and regulated by the Federal authorities. The plans are standardized and a specific plan will offer the same standard features and benefits to the customers irrespective of the location of state within the US. The customers do not have to bother from which insurance company they buy the policies as they will be standardized. The Medicare Advantage plans are not standardized plans and the benefits may vary from different insurance companies.

 

Guarantee Issue

The Medicare Supplement plans can be guaranteed to be issued by the insurance companies only when the applicant applies in the Open Enrolment Plan (OEP) or they have guaranteed issue rights. In other cases, the insurance company can reject to sell the policy based on medical history and pre-existing health conditions. Medicare Advantage plans are available to everyone who have Medicare Part A and Part B.

 

Cost

Medicare Supplement plans have higher monthly premium compared to the Medicare Advantage. However, the Medigap policies have the added advantage of lower out-of-pocket expenses for the customers. The Medicare Advantage costs less than the Medigap policies and has higher service coverage.

 

Network of Doctors and Hospitals

Generally, the Medicare Supplement plans do not limit the customers to visit the doctors or hospitals in their network to avail the policy benefits. The customers can visit any healthcare service provider they are comfortable with as long as they accept the Medicare. Medicare Advantage plans on the other hand limit the customers to visit the doctors and hospitals in their network for availing the policy benefits. Clearly, the Medigap policies provide greater flexibility to the customer in accessing the healthcare facilities for enjoying the policy features and benefits.

 

Benefit Access in Outstation

Medicare Supplement plans provide the flexibility to the customers to avail policy benefits across any of the states in the US. Some Medigap plans also cover the emergency care expenses of the customers in foreign countries. Medicare Advantage plans though, work and offer the benefits to the customers in certain locations only. It will not offer the benefits to the customers in different outstation states or foreign countries.

Includes Prescription Drug Coverage

Medicare Supplement plans do not provide prescription drug coverage. The Medicare Advantage plans offer prescription drug coverage to the customers.