Ten things to remember when comparing Medicare Advantage plans to Medicare Supplement Plans. (Medigap)
- You are not covered under original Medicare program. Medicare contracts with an insurance company to replace the benefits of Medicare.
- Not guaranteed renewable. The company can change or cancel your plan each new calendar year.
- A provider may leave a network at any time during the year. If you see a provider who does not accept the plan’s fee schedule, you may not be covered and may be responsible for part or all of the amounts charged by the provider.
- Between February 15 and December 31 of each year, you cannot change to another plan or go back to original Medicare, except for special circumstances.
- Must cover all services that original Medicare covers except hospice care and some care in qualifying clinical research studies. May offer extra coverage.
- You may be responsible for paying all or part of your doctor or hospital bills if you do not follow the Medicare Advantage plan’s rules.
- The service area for the plan may be limited.
- Some plans require you to obtain a referral from a primary care doctor before you can see a specialist.
- Though these plans must have benefits equivalent to Medicare by itself, they are not required to provide supplemental benefits.
- If you move out of state, you may have to enroll in a new plan.
Medicare Supplement Plans (Medigap)
- You keep your original Medicare coverage.
- Guaranteed renewable for life. The company cannot cancel your plan as long as you continue to pay the premiums. Benefits are coordinated with changes in Medicare.
- You are free to select any doctor or hospital that accepts Medicare.
- You can leave the plan whenever you choose, and still keep original Medicare.
- An insurer may offer, with approval of the commissioner, new or innovative benefits in addition to Medicare’s standardized plans.
- If Medicare covers the medical service provided, the supplement will also cover the service up to the limits of the individual plan you select.
- You are covered wherever you travel throughout the United States.
- No referrals of any kind are required to see a specialist.
- Provides supplemental coverage in addition to Medicare.
- If you move out of state, you can take the plan with you and have the same coverage you have always had.
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