By Christina Finkle
The first thing I generally hear from my new to Medicare clients is, “I need a supplement plan to go with my Medicare.” They are confused and surprised when I tell them, “Actually, you probably don’t.”
The term “supplement” is often used in a general sense, but if you don’t understand the difference, it can lead to confusion. It can also propel you to spend money you don’t necessarily need to spend at this time.
Both a Medicare Advantage plan and a Medicare Supplement plan (Medigap) are offered by private insurance companies, but there are differences. A Medicare Advantage Plan is best utilized when your health is relatively average for your age and demographic, with minor bumps in the road such as, joint replacements, out-patient surgeries, stents, etc.
Some are offered at a zero premium, some have a premium attached. Whichever one you are on is reimbursed by a percentage of the Part B premium you pay to the federal government for administering your health care. All advantage plans MUST offer at the very least, the same benefits you would get if you just stayed on original Medicare. The majority however offer much more above and beyond original Medicare.
A Medicare Supplement plan, also known as a Medigap plan, is best suited for that time in life when your health is failing and probably won’t return to “average” or if you have been diagnosed with something big such as Stage 4 cancer. During either of these situations you know that on average every month your co-pays on an Advantage plan would definitely exceed what a premium for a supplement plan would be. Always remember that a supplement plan does not EVER include a Part D, so you must purchase a stand-alone drug coverage.
Now I am sure you are wondering, “What if? How will I change my plan if something happens?” There are Special Election periods you may qualify for so please do not worry. I will go over those in the future. One however does include EPIC so please do read that article on page 6 of this issue.
If you have a Medicare concern or question you would like addressed in a future article, please feel free to email your question to email@example.com.