My neighbor says I'm crazy for paying for a Medigap plan when Medicare Advantage is "free." What should I tell him?
Answered by 14 licensed agents
Medicare Advantage Plans are not FREE. They may have a $0 premium. However, you must continue to pay your Medicare part B premium to qualify for a Medicare Advantage Plan.
Everyone is different. We all have different genes, needs, preferences etc. Your neighbor does not tell you what food you like, what investments to make and more. Tell them thank you for caring and your advice.
It is true that in Florida around 60% of people turning 65 get Medicare Advantage Plans, but that also means that around 30% get Medicare Advantage.
If you are uncertain about comparing options, I can provide a no obligation comparison specific to your needs and preferences. Just follow the link below and complete my questionnaire. I will get send your personalized comparison when I get your answers.
I help folks in Michigan and after your initial enrollment into medicare here, you will have to health qualify for medigap(supplemental) plans. With our health you never know what is around the corner. If serious health issues wiping out your savings is a concern...and it should be. Medigap plans are the safest option.
Ask them if they can seek treatment (other than an emergency) with any doctor/hospital/facility nationwide that accepts Medicare. Ask them what their annual maximum out-of-pocket is in-network and out-of-network? Ask them if their plan changes from year to year.
I'd reply to your friend with a Medicare Advantage plan by saying: With a Medigap plan, you're free from copays at the doctors and specialists office, and depending on which Medigap plan you have, you don't have to worry about out of pocket costs for hospitalizations.
You can first tell him that nothing is free. Your Medicare Advantage plan may not have a monthly premium, but instead you'll have copays for services that you need, its kind of a pay as you go model. The MediGap plans are designed so that you pay a monthly premium up front, whether you use services or not, and then when you DO use services they are very low cost or free.
Medicare provides multiple choices from which to choose. The selection process is tailored to the clients needs and wants. Medicare also allows, through certain rules and time periods, for a subscriber to switch from one program to another.
All Medicare Advantage Plans are not "free." They all have copays. It is pay as you go and you will need to meet the Maximum out-of-pocket before the plan pays all the costs. If you spend little time at the doctors, a Medicare Advantage works well. But, if you have health issues and are required to attend a physician on a regular basis, Medigaps are a better choice. Also, if you start with a Medicare Advantage Plan, and you have a rather serious health condition come up, you may not qualify for a Medigap later on. Medigap plans travel well in that any place that Medicare is accepted, you can go. It even moves with you from State to State. Medicare Advantage Plans have to be changed; i.e., zip code change. Each individual is different and needs to be fit for that individual. Neighbors don't always know all the circumstances surrounding an individual.
Supplements and Medicare Advantage are equally beneficial. It’s a matter of individual need and budgeting preference. Simply put, a supplement incurs a monthly premium in exchange for coverage of copays and coinsurances relative to the given letter plan. Some Advantage plans do not have monthly premiums in exchange that you do have to pay set copays and coinsurances. In most cases there is a dental, vision and hearing benefit associated with Advantage plans that are not covered by supplements.
Medigap provides very comprehensive coverage for medical care. It does not provide dental,vision, hearing or prescription drugs. These coverages must be purchased separately.
This leads to medigap plans being expensive in comparison to Medicare advantage plans that often cover these items at little to no additional cost.
Both are viable ways to access your Medicare benefits.
Advantage Plans are not free, there are copays , coinsurances when you utilize the services. What you pay for a plan is only one aspect, there are other things to consider. Your coverage, your doctors, network, your health, risk personality as well as your budget.
Everyone had their own needs when it comes to Medicare. An advantage plan may work best for your neighbor but that doesn’t necessarily mean it will be your best option. My best advice is to educate yourself on how they work or meet with a broker who can explain differences between a medigap and an advantage plan
