What's the difference between supplemental insurance and an advantage plan?

Asked by: Mafalda Kautzer  |  Last update: September 15, 2023
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Some Medicare Advantage plans may also offer extra benefits, such as routine dental, vision and hearing services. A Medicare Supplement plan, also called Medigap, isn't bundled with anything—it's extra coverage you can buy to help pay the out-of-pocket expenses Original Medicare doesn't pay.

Is an advantage plan the same as a supplemental plan?

Medicare Advantage and Medicare Supplement are different types of Medicare coverage. You cannot have both at the same time. Medicare Advantage bundles Part A and B often with Part D and other types of coverage. Medicare Supplement is additional coverage you can buy if you have Original Medicare Part A and B.

Can I switch from a Medicare supplemental plan to an Advantage plan?

If your financial situation or your health conditions have changed, it might be time to switch from Medigap to Medicare Advantage. However, you cannot switch at any time. You'll have to wait for the Annual Enrollment Period, which happens every fall from October 15 to December 7.

What does it mean when you have a Medicare Advantage plan?

A Medicare Advantage (MA) plan is a type of health plan offered by a private company that contracts with Medicare to provide you with all your Medicare Parts A and B benefits. MA plans include health maintenance organizations, preferred provider organizations, private fee-for-service plans, and Special Needs Plans.

Is Medicare Advantage a good option?

For many seniors, Medicare Advantage plans can work well. A 2021 study in the Journal of the American Medical Association found that Advantage enrollees often receive more preventive care than those in traditional Medicare. But if you have chronic conditions or significant health needs, you may want to think twice.

Medicare Advantage vs Medicare Supplement Plans (Updated Review and Important Tips)

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Do I still pay Medicare Part B with a Medicare Advantage plan?

Medicare Advantage (MA) plans cover the benefits associated with both Medicare Part A and Part B (except for hospice care, which Part A covers) and may come with a monthly premium for coverage; however, you must also continue to pay your Medicare Part B premium.

Can you go back to regular Medicare after an Advantage plan?

If you're already in a Medicare Advantage plan and you want to switch to traditional Medicare, you should contact your current plan to cancel your enrollment and call 1-800-MEDICARE (1-800-633-4227). Note there are specific enrollment periods each year to do this.

Can you have both Medicare Advantage and Medicare Supplement plans?

You can't have a Medicare Advantage plan and a Medicare Supplement insurance plan at the same time. That means if you're interested in these types of Medicare coverage, you'll need to choose between the two.

Can you have both Medicare and Medicare Advantage?

If you join a Medicare Advantage Plan you'll still have Medicare, but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. You must use the card from your Medicare Advantage Plan to get your Medicare- covered services.

Is Medicare Advantage cheaper?

A Medicare Advantage plan is usually the cheaper overall option for those with low or moderate medical needs, after considering the cost of the plan and expenses for medical care. Medicare Advantage enrollees typically pay very little each month but will pay a larger portion of medical costs.

What is the difference between traditional Medicare and Medicare Advantage plans?

Medicare Advantage: Coverage. Original Medicare covers inpatient hospital and skilled nursing services – Part A - and doctor visits, outpatient services and some preventative care – Part B. Medicare Advantage plans cover all the above (Part A and Part B), and most plans also cover prescription drugs (Part D).

Do Medicare Advantage plans have limits?

Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you'll pay nothing for covered services. Each plan can have a different limit, and the limit can change each year. You should consider this when choosing a plan.

Is it necessary to have a Medicare Supplement?

Medicare supplement plans are optional but could save you big $$$ on doctor bills. Your cost-sharing under Part B is similar. You are responsible for paying your Part B deductible, which is $226 in 2023. Then Part B Medicare only pay 80% of approved services.

What are the two types of Medicare Advantage plans?

Most Medicare beneficiaries who get an Advantage plan enroll in one of two types:
  • HMO (health maintenance organization) plans.
  • PPO (preferred provider organization) plans.

Is Humana Gold Plus a Medicare Advantage plan?

Humana Gold Plus H6622-032 (HMO) is a Medicare Advantage HMO plan with a Medicare contract. Enrollment in this Humana plan depends on contract renewal.

Do I have to pay for Medicare Part D if I have supplemental insurance?

You're required to pay the Part D IRMAA, even if your employer or a third party (like a teacher's union or a retirement system) pays for your Part D plan premiums. If you don't pay the Part D IRMAA and get disenrolled, you may also lose your retirement coverage and you may not be able to get it back.

Is Medicare Supplement always secondary to Medicare?

Is a Medicare Supplement Plan Primary or Secondary? Medicare Supplement plans are secondary payers to Medicare. The facility where you receive care will bill Medicare first.

Can you have Medicare and UnitedHealthcare at the same time?

In most cases, you are automatically enrolled if you qualify. Most UnitedHealthcare dual-eligible plans do not charge a separate monthly premium. People eligible for Medicare may also qualify for the program that helps lower the cost of prescription drugs.

What costs count toward the out-of-pocket maximum for Medicare Advantage MA plans?

The out-of-pocket costs that help you reach your MOOP include all cost-sharing (deductibles, coinsurance, and copayments) for Part A and Part B covered services that you receive from in-network providers. Part D cost-sharing does not count towards your plan's MOOP.

How much is Medicare Part B?

Most people pay the standard Part B monthly premium amount ($164.90 in 2023). Social Security will tell you the exact amount you'll pay for Part B in 2023. You pay the standard premium amount if you: Enroll in Part B for the first time in 2023.

What happens to my Medicare disability when I turn 65?

When you turn 65, you essentially lose your entitlement to Medicare based on disability and become entitled based on age. In short, you get another chance to enroll, a second Initial Enrollment Period if you will.

How do I get my $144 back from Medicare?

To qualify for the giveback, you must:
  1. Be enrolled in Medicare Parts A and B.
  2. Pay your own premiums (if a state or local program is covering your premiums, you're not eligible).
  3. Live in a service area of a plan that offers a Part B giveback.

Do Medicare Advantage plans have to cover everything Medicare covers?

Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you're in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you're always covered for emergency and urgent care.

Do Advantage plans cover Part B premiums?

If you enroll in a Medicare Advantage plan with this benefit, the plan carrier will pay some or all of your Part B monthly premium. The amount covered can range from 10 cents to the full Part B premium cost ($164.90 in 2023).