The decision Medicare Beneficiaries must make when it comes to picking an insurance, do I go with Medigap or Medicare Advantage? Now both types of policies have great benefits, but it is ultimately up to the member to determine what features they're looking for when it comes to a new policy.
Are You Looking For Affordability or Portability?
What is a Medigap Policy?
About two-thirds of the 61 million seniors and disabled Medicare beneficiaries choose traditional Medicare, Parts A and B, which cover hospitals, doctors, and medical procedures. About 80% of these beneficiaries supplement their insurance with Medigap (Medicare Supplement) insurance, Medicaid, employer-sponsored insurance, and/or stand-alone Medicare Part D prescription drug policies.
Medicare Supplement insurance plans are provided by private insurers and are not connected/endorsed in any way by the United States Government. Instead, Medicare funds Medicare plans to provide benefits.
Traditionally, Medicare Supplement Plans are the more expensive options when it comes to picking a plan, but it has some amazing features. When you have a Medigap plan to supplement your Original Medicare, you are covered for any hospital or doctor visit/procedure in the United States that accepts Medicare. These means that you can travel anywhere across the U.S. for medical services. You do not need a referral for services. a Medigap (Supplement) Policy is great for someone who travels a lot or that has specific providers they see that are in different states.
What is a Medicare Advantage Plan?
Available from private, Medicare-approved insurance companies. Medicare Advantage Plans are labeled under (Part C) and include all of Medicare Part A, Medicare Part B, and in some cases even include Prescription Drug Benefits (Part D).
In Southern Nevada, Medicare Advantage Plans are marketed and provide by Major Insurance Carriers. Local, they may have no premium or a lower one compared to the significant premiums for Medigap and prescription drug insurance policies. Just like Medigap Policies, Medicare Advantage plans cover hospital and doctor visits/procedures, but with little to no copays. In most instances they include prescription drug coverage and they also cover many services that are not covered by Medicare.
Locally, Medicare Advantage plans operate at HMO's or PPO's. A little more than one-third of Medicare beneficiaries choose one of these plans.
Medicare Advantage Plans require its members to stay in network when receiving care. If they choose to elect services out of network or without a referral, the member would be subject to 100% of the cost of the service. It's important to be aware of this when considering a Medicare Advantage Plan, but typically when members receive care within network, they are responsible too little or no copay's for services. This is why Medicare Advantage Plans are so appealing, they have little to no out-of-pocket expenses.
Ultimately, It Is A Big Decision When Figuring Out What Type of Medicare Policy Is Right For You
Good news is that there are many reasons why a person could change their plan. Take the time and evaluate your needs, then get in contact with Comprehensive Medicare Solutions. We are contracted with every major insurance carrier in Southern Nevada and are happy to help Medicare Beneficiaries find the right plan that fits their needs.
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