When we have a client meeting with someone Turning 65 and receiving Medicare, the number one question from them is…What would you get, a Medicare Supplement or Medicare Advantage Plan?

If only the answer was easy.  Close to half our clients are on Medicare Supplement plans and the other half are on Medicare Advantage Plans.  There is no clear answer that points to one being better than the other.

What we have found to be true is the old saying “different strokes for different folks”.  Everyone is different and by asking questions it helps narrow down what plan would be best for each individual person.

Are they in good health, do they travel a lot, do they like saving money and taking risk or having a higher budget for health expenses with less risk?

All these factors and more play into what the best choice for each individual person would be.

Some Advantages of Medicare Supplement

• No network: a Supplement like Medicare allows you to go to any doctor or hospital that accepts Medicare.  We never have to ask someone who will be getting a supplement who their primary doctor or specialist is or what hospital would they like to go to.  If a Senior is planning on doing a lot of travel through the United States a Medicare Supplement can be a win, win.  For example, if they lived in Ohio but spent 3 months in Florida, they could setup a surgery in Florida and not have to come back to Ohio for it.  If a procedure they needed was only done at the Mayo Clinic they would be able to go, there and have it done.  Medicare Advantage Plans have HMO networks – must make sure your doctor or hospital are in network and PPO networks – can go see doctor or hospital out of network for higher cost.

• Budget your expenses: Medicare pays first, and the Medicare Supplement will come in second to pay the rest depending on what Plan letter you have.  For example, Plan G will pick up everything that Medicare will approve and have you pay for accept the one time a year doctor deductible of $233 in 2022.  No matter how bad one’s health is in 2022 that individual will pay the same premium for that Plan G Medicare Supplement and their one time a year deductible of $233 and nothing more if Medicare approves the claim.  With a Medicare Advantage plan, you can pay little or a lot depending on your health. In 2020 for Medicare Advantage enrollees, the average out of pocket limit is $4,925 for (HMO) in network services and $8,828 for both in network and out of network services (PPO).

Some Advantages of Medicare Advantage Plans

• Save on premium: Many Medicare Advantage Plans start out as low as $0 a month premium.  If you’re in good health and experience fewer co-pays and co-insurance, this can save you a lot of that premium that would go to the Medicare Supplement. 

• Comes with Prescription coverage: With a Medicare Supplement you would have to pay a monthly premium to get a stand-alone RX plan too.  But most Medicare Advantage Plans include a prescription plan in the $0 monthly premium.

• Extras like dental, vision, gym membership and more:  Most Medicare Advantage plans come with dental coverage and extras like eyewear, low-cost co-pays for hearing aids, free gym memberships etc.  Medicare and a Medicare Supplement do not cover dental, eyewear or extras like hearing aids.  You would have to obtain separate coverage for these type of things at a premium cost.

We have put together a chart that helps give a comparison of apples to apples when it comes to Medicare Supplement vs Medicare Advantage Plans.  See chart below.

Our role as insurance agent is to find out what individual plan would be best for you for a Medicare Supplement with stand alone RX Plan or Medicare Advantage Plan.   Once we show are clients both options then they must make the final decision. 

Sometimes the client will answer that question for themselves.  For example, if a client is worried about each co-pay, they could have with a Medicare Advantage Plan then maybe going with a Medicare Supplement will give them more peace of mind and good night’s sleep.

We would love to help you find the Plan would be best for you.  Contact us at 216-659-7230 or by email at dave@evergreenrs.net