Which is better, Medicare Supplement (Medigap) or Medicare Advantage? This is a question that many people turning 65 will be asking themselves. In my opinion, all things considered equal Medicare Supplement Plan F would be the best option. Plan F covers the Part A and Part B co-insurance and Part A and Part B deductibles. Therefore, most if not all out-of-pocket costs will be paid by Original Medicare and Medicare Supplement Plan F. However, Plan F will probably be the plan with the highest premium.
A Medigap does not include Medicare Prescription Drug benefits. This means that you would have to purchase a separate Part D plan (PDP) which will add to your monthly cost for health insurance.
Medigap plans are standardized which means that Plan F will offer the same benefits regardless of which insurance company you purchase it from. The other Medicare Supplement plans are A, B, C, D, F, High Deductible F, G, K, L, M and N. All insurance companies that sell Medicare Supplements must offer Plan A. Rates, plans and insurance companies selling Medicare Supplements vary from state to state.
A Medicare Advantage plan could be a good alternative to Original Medicare. Many of the plans include the Part D. Premiums for Medicare Advantage plans are generally lower than Medicare Supplement Plans. Some Medicare Advantage plans have zero premiums. Medicare Advantage plan benefits vary from county to county. Many Medicare Advantage plans offer additional benefits that Medicare doesn’t cover such as dental, vision or a free membership to a gym.
When considering Medicare Advantage HMO, PPO and POS plans you have to check to see if your doctors are contracted with the plans and what your out-of-pocket expenses will be for each covered service. Technically you can go to any doctor under a PPO plan. But if the doctor doesn’t take the PPO you would have to pay the doctor his fees and get reimbursed by the plan later. If it’s a PFFS plan, you have to check with your doctors to see if they would accept it. Keep in mind, that a provider can refuse to accept a PFFS plan at any time, even if they have accepted it before.
Everyone’s situation is unique and their needs are different. I believe that it is important for seniors to do plenty of research, consult with people you trust and try to make the best decision for you.