Medicare Advantage Plans are insurance based options that take over for Medicare parts A, B and usually D. These are comprehensive plans that make seniors have more predictable healthcare costs. Medicare actually pays the insurance company a flat rate per month to cover you and the insurance company is then at risk. Most Advantage plans are HMO and PPO related and you need to make sure the doctors that you currently like and use are part of that plan.

Components of a Medicare Advantage Program

1. Very comprehensive plans and patients have predictable costs
2. Will always include hospital coverage & physician coverage and most likely will include a drug benefit.
3. Usually no deductibles or coinsurance, just co-pays.

Medicare Medigap Plans are federally regulated and designed by Medicare but are sold by insurance companies. Forty-seven of the fifty states (all but Mass, Minnesota and Wisconsin) sell the exact same 10 Medigap plans that are designed by Medicare but handled and priced by private insurance companies. The plans are initial based (A, B, C, D, F, G, K, L, M & N) and insurance companies do not have to sell them all. In Minnesota you have two comprehensive plans to choose from: Basic and Extended Basic (“riders” are available).

Components of a Medigap Plan

• The plans concentrate on filling the gaps of Medicare A & B by paying the coinsurance, co-pays, and deductibles that you pay with just regular Medicare A & B.

Action Step: Both Medicare Advantage & Medicare Medigap can be complex products and it is a great idea to always have a 2nd pair of eyes review them before signing.

Golden Nugget: Some Medicare Advantage Plans give you $ to join….How? Because Medicare will pay the insurance company a flat rate to take over Medicare services, there are certain situations and plans that feel they can afford to pay you money if you join their plan. You need to make sure the situation has you covered sufficiently but there are instances where this really happens.