Much has been published on the internet comparing Arizona Medicare Advantage to Arizona Medicare Supplement Plans. As an independent Medicare Broker in Arizona, it is the most common concern of Medicare Beneficiaries that I run across.
are so different from Medicare Supplements and since each beneficiary has their own needs, I won’t recommend any plan in this post. All I will provide is a short overview of each plan.
Medicare Advantage plans are private Medicare health plans that you can choose to enroll into instead of Medicare. You never lose your Medicare, but during the time that you are enrolled in a Medicare Advantage plan, your providers must bill your plan. Medicare Advantage plans sometimes they are referred to as Medicare Part C. These plans function similar to group insurance you may have had in the past, where you will pay copay for various services. You may have a copay for your primary care physician and a higher copay for a specialist. Copay you will also apply to lab-work, surgery, ER visits, hospital stays, etc.
In Arizona most of the plans are an HMO or PPO, so you will need to use the plan’s network of doctors and hospitals. It’s very important to check with your favorite doctors to make sure they are in the plan’s network before you enroll into a Medicare Advantage plan.
These plans also often include the Medicare Part D drug plan rolled right in. So you will have just one card that you present at the pharmacy and at the doctor’s office, and you can stash your original Medicare card away in a safe place because you won’t be using it.
Some key points to keep in mind with a Medicare Advantage plan
- You must still pay for your Medicare Part B unless you qualify for Medicaid or another Medicare Savings program
- Medicare Advantage plans are often less expensive than supplements. Some even have premiums as low as $0/month. This is because you have agreed to share in some of your costs, such as doctor co-pays and hospital stay co-pays
- Each Medicare Advantage plan has an out of pocket limit on your annual spending.. If you hit the maximum in any given calendar year, the plan pays 100% of the cost of your Medicare-approved medical services for the rest of the year
A common name for A Medicare Supplement plan is a Medigap plan. That’s because Medicare has gaps in the form of deductibles and copays that the beneficiary still has to pay. A Medicare supplement or Medigap is a private insurance company that provides plans that fill in some of these gaps.
Some key points to keep in mind with a Medicare Supplement Plan
- You stay enrolled in Original Medicare A & B, Medicare pays their portion on a claim and then the Supplement company pays their share.
- Since you are still enrolled in Medicare, you can see ANY treatment provider or hospital that accepts Medicare, regardless of which Medicare supplement company you choose. This is one of the main benefits of many beneficiaries.
- Monthly premiums for your supplement coverage are in addition to what you pay for Medicare Part B
- Medicare Supplement plans are standardized which mean if pick a plan from company A that plan with Company B must be the same. Each company determines their premium which can vary considerably
- Supplement plans do not include retail prescription drug coverage called Part D. Prescription drug plans are available from several companies and are taken out separately.
Once again find a good competent Medicare Broker in your area. Sit down with him or her and ask questions until you feel that you are ready to make a decision.