Introduction to Medicare Advantage Plan Information
Why Would I Want to Supplement Medicare?
Medicare is the federal health insurance program for:
- People who are 65 or older
- Certain younger people with disabilities
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
The different parts of Medicare help cover specific services:
- Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. - Medicare Part B (Medical Insurance)
Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. - Medicare Part D (prescription drug coverage)
Helps cover the cost of prescription drugs (including many recommended shots or vaccines).
Original Medicare, specifically Parts A & B, covers most of your medical costs. However, there are still uncovered costs, such as prescriptions, co-pays, deductibles, etc. This is why you may to consider additional coverage.
What Are My Choices to Supplement Medicare?
You can choose to enroll in Medicare (typically at minimum Parts A & B) or a Medicare Advantage Plan. Both alternatives will provide for health coverage. To add to the confusion, you can also select a Medigap Plan to supplement Medicare. It may sound simple, but can be confusing, which gave me cause to post this article on all three components, which includes several expert resources.
Medigap Versus Medicare Advantage
Medicare enrollment in Parts A & B by itself is relatively simple. However, the different options can be very confusing. To add to the confusion, to qualify for the Medicare Advantage Plans, you must also be enrolled in Medicare (Parts A and/or B).
If you choose Original Medicare, but not Medicare Advantage, you can also opt for a Medigap Policy. Is the confusion growing? This is why I have provided several useful links below to help you sort these issues out.
Medicare Basics – Medicare.gov
This article from Medicare.gov was the simplest one I found that describes the basics of Medicare and its components. Be sure to select the button for Parts of Medicare to learn more about these components:
- Original Medicare
- Medicare Advantage Plans
- Medigap
How Does Medicare Work? – Medicare.gov
This article is actually one of the buttons from the Medicare Basics site above. It explains how Medicare works with Medicare Advantage Plans.
Learn How Medigap Works – Medicare.gov
This article explains at a high level how a Medigap Policy can supplement Original Medicare (Parts A & B). I have added the article below, from AARP to provide more detail.
How are Medigap and Medicare Advantage different? – AARP
This article provides more detailed information about both Medigap and Medicare Advantage plans. I would consider this a go to resource.
Compare types of Medicare Advantage Plans – Medicare.gov
This table compares basic characteristics and benefits of HMO, PPO, PFFS, SNP and MSA type Medicare Advantage Plans.
The Pros and Cons of Medicare Advantage – Consumer Reports
Though almost half of Medicare recipients have chosen to enroll in Medicare Advantage Plans, this article cites that the plans are not without risks.
Finding a Medigap Plan
Find a Medigap policy that works for you – Medicare.gov
A short webpage provided by Medicare, which gives you a 3-step process on how to find and enroll in a Medigap policy. Be sure to check out the “7 Things to Know about Medigap” link that is located after Step 3.
How to Find the Right Medigap Policy for You – AARP
This article is frankly more detailed and helpful than the article from Medicare.gov
Finding a Medicare Advantage Plan
Best Medicare Advantage Plans in Each State for 2024 – US News and World Report
“Parsing the pros and cons of Medicare plans can be challenging. Individuals must decide between traditional Medicare with a Medigap plan to minimize out-of-pocket costs or opt for Medicare Advantage, which typically has lower premiums but higher copays. Key considerations include the service network size and prescription drug coverage.
To aid in decision-making, U.S. News identified the best Medicare Advantage plans for 2024, based on the Centers for Medicare and Medicaid Services (CMS) star ratings. Important criteria for selecting a Medicare Advantage plan include provider network size, monthly premium costs, and coverage for services like physical rehabilitation, ambulance use, dental care, and vision services.
U.S. News provides a tool for Medicare-eligible individuals to find suitable plans, using data and star ratings from CMS. The top-rated Medicare Advantage plans are listed by state, with companies earning a “Best Medicare Advantage Plan” designation if they offer plans in at least 10 states and achieve high star ratings from CMS. Additionally, the best companies for Medicare Part D Prescription Drug Plans for 2024 are highlighted. It is recommended that individuals compare plans available in their area.”
Best Medicare Advantage Plans Of 2024 – Forbes
“Medicare Advantage, also known as Medicare Part C, is a popular form of health insurance coverage for U.S. adults age 65 and older. Selecting the best Medicare Advantage plan and provider for you can be complicated—nationwide, insurance providers offer thousands of different Medicare Advantage plans each year.
To determine the best Medicare Advantage providers, the Forbes Health editorial team evaluated U.S. insurance companies that offer plans nationwide by how many states they provide coverage in, the types of benefits they offer, how the Centers for Medicare and Medicaid Services (CMS) ranked their plans, how agencies like A.M. Best ranked them in terms of their financial health, how agencies like J.D. Power ranked them in terms of consumer feedback and more. Read on to see which providers made the list.”
Resources
- A 7-Point Checklist for Choosing a Medicare Advantage Plan – National Council on Aging
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