​Medicare Supplement plans – also known as Medigap plans – are designed to cover some of the costs that Original Medicare doesn’t. These costs include things like copayments, coinsurance and deductibles. Some Medigap plans also offer certain benefits that Original Medicare doesn’t like emergency foreign travel expenses. Medigap plans don’t cover your costs under other health plans – including Medicare Advantage Plans – but only the costs that Original Medicare doesn’t cover.
Here’s how it works. If you have Original Medicare and a Medigap policy, Medicare will pay its share of the Medicare-approved amount for a covered service. Then, your Medigap policy pays its share. But Medicare doesn’t pay any of the costs of purchasing the policy.
Medigap Plans differ from Medicare Advantage Plans in an important way. Medicare Advantage Plans are just an alternative way to get your Medicare Plan A and B benefits. Medigap Plans are solely designed to cover costs that Original Medicare doesn’t cover. In fact, insurance companies generally can’t sell you a Medigap Plan if you are already covered by a Medicare Advantage Plan or Medicaid. Medigap Plans are required to follow all federal and state consumer protection laws and policies must be clearly identified as “Medicare Supplement Insurance.” Medigap Plans in most states are standardized, and identified by Plan letters A through N. Each standardized state Medigap plan under the same plan letter must offer the same basic benefits, no matter what insurance company sells it. Usually, the only difference between Medigap policies with the same plan letter is the cost charged by different insurance companies… so you can comparison shop!
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​Medicare Advantage plans are an alternative to basic - or so-called Original - Medicare. Sometimes referred to as Medicare Part C or MA Plans, they are offered by Medicare-approved private companies. They must follow Medicare rules and provide Medicare Part A and B coverage. Most Medicare Advantage Plans also include Part D drug coverage.
In many cases, you can obtain the lowest plan rates by using an in-network provider in your area. Some plans do have an out-of-network option, but it will sometimes be at higher cost. An attractive benefit of Medicare Advantage plans is that they set a limit on the amount you pay out-of-pocket for covered services annually, which helps protect you from unexpected expenses.
When seeking treatment, you must present your Medicare Advantage card to receive Medicare covered treatment.
The most common types of Medicare Advantage plans are Health Maintenance Organization or HMO Plans, Preferred Provider Organization or PPO Plans, Private-Fee-For-Service or PFFS Plans, Special Needs Plans or SNPs. Each type has its own set of benefits, costs and limitations, so be sure to research your choice carefully. But no matter what plan you choose, do not discard your red, white and blue Medicare card, because you’ll need it if you ever decide to switch back to Original Medicare.
Let us help you with your important Medicare decisions. Call to speak to a licensed insurance agent.