COMPARISON

MEDICARE SUPPLEMENT

MEDICARE ADVANTAGE

ELIGIBILITY

• Must have Medicare A & B.

• Applicants may have guaranteed issue rights during certain enrollment periods, otherwise may have to pass a health questionnaire.

• Must have Medicare A & B.

• Plans are guaranteed issue as long as you do not have ESRD.

• Must live in service area 6 months of the year.

COSTS

• Premiums for the same plan differs from company to company.

• Typically more expensive than Medicare Advantage plans.

• Premiums differ based on unique plan designs from private insurers.

• Typically less expensive than most Medicare Supplement plans.

BENEFITS

• Plans are standardized and generally don't change.

• Plans can change on an annual basis and members may change plans during Annual Enrollment Period.

• Plans may have a deductible, copays, coinsurance, and out-of-pocket limits.

PROVIDER NETWORK

• Most plans cover any provider in the USA who accepts Original Medicare.

• Referrals to access specialists are typically not required.

• Foreign travel ER coverage limited to $50,000 per lifetime.

• Plans use defined network of providers (HMOs, PPOs, etc.) that may require referrals to see specialists.

• Will cover ER visits anywhere in the US and usually worldwide.

PRESCRIPTIONS (RX)

• Does not include Part D Rx coverage.

• You will need to purchase a separate Medicare Part D Rx plan.

• Most plans include Part D Rx coverage as part of the plan's standard monthly premium.

EXTRAS

• These standardized plans do not offer the “extras” that Medicare Advantage plans often deliver.

• Many plans offer free fitness memberships.

• Some plans offer benefits that Original Medicare does not cover, such as vision, dental, and hearing coverage.

• Many plans offer health and wellness benefits such as free fitness memberships.