Medicare Supplement vs. Medicare Advantage

Here's a quick overview about these two types of plans and how they compare. We can help you decide which type of plan best suits your specific needs.


COMPARISON

MEDICARE SUPPLEMENT

 

MEDICARE ADVANTAGE

 

ELIGIBILITY

  • Must have Medicare A & B.
  • Applicants may have guaranteed issue rights during certain enrollment periods, otherwise may have to pass a health questionnaire.
  • Must have Medicare A & B.
  • Plans are guaranteed issue as long as you do not have ESRD.
  • Must live in service area 6 months of the year.

COSTS

  • Premiums for the same plan differs from company to company.
  • Typically more expensive than Medicare Advantage plans.
  • Premiums differ based on unique plan designs from private insurers.
  • Typically less expensive than most Medicare Supplement plans.

BENEFITS

  • Plans are standardized and generally don't change.
  • Most popular "Plan F" has no deductible, no copays, and no out-of-pocket limit.
  • Plan F is 100% coverage for Medicare-covered services.
  • Plans can change on an annual basis and members may change plans during Annual Enrollment Period.
  • Plans may have a deductible, copays, coinsurance, and out-of-pocket limits.

PROVIDER NETWORK

  • Most plans cover any provider in the USA who accepts Original Medicare.
  • Referrals to access specialists are typically not required.
  • Foreign travel ER coverage limited to $50,000 per lifetime.
  • Plans use defined network of providers: HMOs, PPOs, POS, etc.
  • Will cover ER visits anywhere in the US and usually worldwide.
  • Foreign travel ER coverage not limited to $50,000 per lifetime.

PRESCRIPTIONS (RX)

  • Does not include Part D Rx coverage.
  • You will need to purchase a separate Medicare Part D Rx plan.
  • Most plans include Part D Rx coverage as part of the plan's standard monthly premium.

EXTRAS

  • These standardized plans do not offer the extras that Medicare Advantage plans often deliver.
  • Most plans do not offer SilverSneakers although some do.
  • Some plans offer benefits that Original Medicare does not cover, such as vision, dental, and hearing coverage.
  • Many plans offer health and wellness benefits such as SilverSneakers gym memberships.

Got Questions? Contact us or call 425-353-9763 (TTY: 711).