Medicare Advantage Plans vs. Medicare Supplemental Insurance Plans

Senior citizens who are eligible for Medicare are faced with choosing a Medicare plan that best suits their needs. However, this can be very confusing since there are several options available. Basic Medicare is not enough insurance to cover most individuals. Therefore, there are two options available in which seniors must choose from to supplement their Basic Medicare. The two plans are Medicare supplements and Medicare Advantage plans. It is very important to know the difference between these two plans in order to determine which plan is best as they are easily confused with each other.

Medicare supplements are insurance policies that can be purchased by seniors to cover the gaps left by Medicare. This insurance is often referred to as Gap Insurance. The gaps that are left include, coinsurance, deductibles, copays, laboratory expenses, surgeries, hospital stays, as well as other unforeseen medical expenses. There are dozens of Medicare Supplements out there to choose from, and they all cover the same type of services. Even though all Medicare supplement insurance companies provide coverage for the same service, they don’t all provide the same amount of coverage. Therefore, you need to take into consideration where you stand as far as your health to determine which plan is the best financial choice. Plans can get pricey depending on the amount of coverage. It may be cheaper for someone who rarely goes to a doctor to choose a plan with more out of pocket expense rather than paying higher premiums. All doctors and medical facilities that accept Medicare Insurance accept Medicare Supplement insurance. On average, Medicare Supplement quotes run around $150 per month.

Medicare Advantage Plans are private insurance companies that receive subsidy from Medicare Insurance. Medicare pays the private insurance company a premium to cover the individual. Medicare is essentially selling your insurance to the private insurance company. Your Medicare Advantage Plan is then liable to pay all of your covered benefits. All Medicare Advantage Plans are required to provide the same coverage as Medicare-covered benefits. Medical Advantage Plans include Health Maintenance Organizations (HMOs), Private Fee-for-Service Plan (PFFS) and Preferred Provider Organization (PPOs). Since these plans are private owned companies they have their own network of doctors and facilities. If you choose to use a provider out of network you may have to pay out of pocket costs. These cost are usually deductibles, co-pays and unreasonable charges incurred by non-participating doctors and facilities. Therefore, it is wise to find and establish doctors within your network. The biggest advantage to choosing a Medicare Advantage Plan is that the average premium is approximately $50 per month and sometimes free. The disadvantage is not every Medicare provider accepts these plans.

Understanding Medicare

Medicare is a program that helps millions of American seniors acquire affordable health insurance coverage.  Unfortunately when people are making the transition to Medicare they are met with tons of confusing pieces of mail and advertisements.  The reality is that Medicare can be simple to understand once you break it down.

Parts of Medicare

There are three main parts of Medicare Part A, Part B and Part D.  There is also a Medicare Part C but it is really a private insurance program called Medicare Advantage, which takes you out of Medicare and on your own private insurance plan.  Medicare Part A was the first to come into existence and helps with Hospital Coverage.  Medicare Part B was created shortly after and will help you with well patient and out patient services like visiting your local doctor’s office.  Finally Medicare Part D was created and it is there to help seniors pay for prescription drug coverage.

Costs of Medicare

Medicare is not completely paid for and each part will cost you money if you use the service.  Medicare Part A does not cost most people a monthly premium but there is a deductible and coinsurance for each piece of its coverage.   Medicare Part B has a monthly premium of $104.90 (2013).  Part B also has a deductible of $140 and ongoing coinsurance of 20% off your medical expenses.  Part D has a monthly premium that varies based off of what prescriptions you need.  While this seems like it could add up fast there are ways to lower these costs.

Medicare Supplement Plans

Medicare supplemental insurance was introduced to help seniors cover the gaps left in the coverage from Medicare Part A and Part B.  There are ten Medicare supplement plans that will fill all or only a few of the coverage gaps, depending on which plan you choose.  The plans are identical from state to state, with the exceptions of Wisconsin, Massachusetts, and Minnesota who have adopted their own plans. That means if you buy Florida Medigap F, you will have the same coverage as someone who buys Texas Medigap F.

Although slightly more expensive, the Medicare supplement insurance plans that fill most or all the gaps, like Medicare supplement plan F and plan G, will make sure that you do not have to pay anything additionally out of pocket.  If you have any additional questions you should seek the advice of a competent Medicare supplement insurance agent.

Car Insurance Can Fail You

Car insurance is supposed to be our safety net for unexpected hazards on the road, but what happens when that net is full of holes? Your “full car insurance coverage” may provide you with less coverage than you realize when you read the fine print in your policy.

Bill Wilson, associate vice president of education and research for the Independent Insurance Agents & Brokers of America, was recently quoted as saying, “Insurance is not a commodity. Buying an auto policy is not the same as buying a 2-pound bag of sugar.”

It is more like buying a bicycle he says. You need to evaluate features on the bike, the company’s reputation, and match the product with the way you plan to use it.

And that is why it is important to compare both car insurance quotes and policy details before making a buying decision.

Here are a few things you want to keep your eye out for.

Underinsured motorist coverage that is confusing

This coverage kicks in when the driver at fault does not have enough liability coverage to pay all of your medical bills after you are injured in an accident.

Sounds pretty straight forward, does it not? Well, the payout is not always so simple. The amount paid from the at-fault driver’s liability is deducted from the amount that you can claim against your own underinsured motorist coverage.

For example, let’s say that you are confronted with $35,000 worth of medical bills for injuries from a car accident. The at-fault driver has $20,000 in bodily injury liability coverage, and you have $15,000 in underinsured motorist coverage.

The $20,000 from the other driver’s policy would be deducted from what you can claim on your $15,000 of underinsured motorist coverage. This would result in your coverage paying nothing, and you would be $15,000 short of the $35,000 you need.

No coverage for injuries if you drink and drive

Currently, 37 states have alcohol-exclusion laws, which allow insurance companies to deny medical coverage for injuries due to intoxication. If you live in one of those states, your insurance company could be within their legal rights to refuse to pay for your medical treatment if your accident was the result of driving impaired by alcohol. Obviously, the best decision is to not drive, even after just one or two drinks. In some states, you can reach the legal limit of being impaired after just one drink.

Restricted coverage for car theft

Some auto insurance policies exclude coverage for theft without any evidence of a forced entry into your vehicle. Others do not offer coverage for upgraded or custom equipment, which can be a problem if you have made some modifications to your vehicle.

These are just some of the areas where your coverage may not be sufficient, but it is only the tip of the iceberg.

When looking for a new auto policy, it is always best to work with an insurance agent who understands your needs and can explain the differences among policies.