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Medicare Supplements vs. Medicare Advantage

Both Medicare Supplements and Medicare Advantage plans are great coverage. We have about half of our clients on each, so we’re not the ones to tell you that one is great and the other is trash. Be careful of people who do. The truth is that it depends on your situation.

Here’s a breakdown of the two options. Note that these are estimates, the numbers and benefits will depends on the specific plan that you select.

IMPORTANT: On each plan, you still must pay your Part B monthly premium!

Deciding Factors

These are some common deciding factors:

1. Budget – Many seniors are on a low, fixed income that does not allow them to afford the monthly premium of a Medicare Supplement plan.

2. Travel – If you travel out of state frequently, you may prefer the freedom on a Medicare Supplement plan where you can go to any doctor in the entire country who accepts Medicare.

3. Health – If go to the doctor frequently and have pre-existing conditions, it may be more expensive for you if you select a Medicare Advantage plan.

4. Risk Tolerance – Some seniors just don’t like the risk of having out of pocket expenses on a Medicare Advantage plan. They would rather pay more each month for a Supplement, knowing that if they get sick, they will have the peace of mind that comes from having full coverage.

What Plans Are We Personally On?

Both Dick & Margaret Gordon are each on Medicare, so their personal plan choices can be a good example.

Margaret Gordon - Medicare Supplement Plan G

Margaret Gordon is on a Medicare Supplement Plan G. She loves to pay her monthly premium and not have to worry about what any of her procedures are going to cost. Her knee / hip replacement were covered at 100% after she met her yearly Part B deductible. 

When she travels to Florida in the winter, she likes the flexibility of being able to go to any doctor/hospital that accepts Medicare without having to worry about networks and referrals.

She understands that the price of her Medicare Supplement goes up a bit every year, but she enjoys the peace of mind of knowing that her coverage does not change.

Dick Gordon - Medicare Advantage PPO

Dick Gordon is on a Medicare Advantage PPO plan. He only goes to the doctor a couple times per year and doesn’t want to pay a high premium for something he isn’t using. He knows that if he has gets sick, that he’ll have to pay more, but that’s ok because has enough money set aside to pay for those costs. 

When he travels to Florida in the winter, he uses his plan’s “Passport” option which assigns him an in-network doctor that he can go to. He also knows that if he even has an emergency, he’s always considered in-network.

He understands that his PPO plan  changes every year, so he makes sure his doctors and prescriptions are covered during the Annual Election Period each year.

FAQs

There is no "Best plan" overall, it all depends on your situation.

 

If you can qualify for a Medicare Supplement and have the money to afford it, that is a great option.

Your initial decision between a Medicare Supplement or Advantage plan may be final. That's because once you pass your Open Enrollment period, you will have to pass health underwriting in order to switch to a Medicare Supplement.

 

If you start on a Medicare Supplement, you can always switch to a Medicare Advantage plan during the Annual Election Period without any health qualifications.

Summary

In conclusion, there is no overall best option. There is however a best option for your situation.

At The Medicare Family, our personal opinion is that, many times, it makes sense to start on a Medicare Supplement plan because you always have the option to switch to a Medicare Advantage plan during AEP if you change your mind.

If you start on a Medicare Advantage plan, your ability to get a Medicare Supplement plan in the future will depend on whether or not you can qualify based on your health.