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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.

How to Decide Between the Two Options

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. In that case, we focus on how to find you the best Medicare Advantage plan and potentially fill in coverage gaps with Hospital & Cancer coverage.

2. Travel – If you travel out of state frequently, you will likely prefer the freedom on a Medicare Supplement plan on which you can go to any provider in the entire country who accepts Medicare (over 95% do). 

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. The co-pays of $20-$50 at the doctor can add up quickly on Advantage plans.

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.

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

What Plans Are We Personally On?

Both Richard & Margaret Gordon, founders of The Medicare Family, are 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.

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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.

Update: For 2023 Mr. Gordon moved to a Medicare Supplement Plan G
The family felt it was unwise for him to continue on a Medicare Advantage plan into his 90’s, especially since he was able to afford and qualify for a Medicare Supplement.

FAQs

Which is Best: Medicare Advantage or Supplement?

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.

Is my decision final? Can I switch between the two?

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.

Sylvia Gordon, aka Medicare Mama®, is an expert on all things Medicare and Social Security. She is the 2nd Generation here at The Medicare Family and has served on the advisory boards of major insurance companies like UnitedHealthcare®, Cigna, and Anthem. In her free time, she can be found taking care of her animals (dogs, goats, peacocks, chickens), and reading a good book. Learn More.
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For 40 years, our family has been helping seniors understand their Medicare benefits and find the best plan for their unique situation – the best part? Our service is always 100% free to you!

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