So you’re wondering what the difference is between original Medicare with a Medicare supplement plan and Medicare Advantage plan.
My name is Evan Fein from Senior Reserve Group Medicare Specialist, and I’m going to answer that question for you clearly today.
Feel free to watch the video below that answers this question, or continue reading below.
The Differences Between Medicare Plans – Watch the Video
So the first option we have is original Medicare with a Medicare supplement plan and a prescription drug plan.
With original Medicare, Part A and B will be your primary insurance.
After that, your Medigap or Medicare supplement plan will pay second.
With this option, you will have a little bit of a higher upfront cost in premiums, but much lower out-of-pocket when you use the plan.
Also, you can visit any doctor in the country that takes Medicare, which is 97% of doctors at every major hospital.
Original Medicare vs. Medicare Supplement Plan
With original Medicare, there is no prior authorization for any services.
So if you need your physical therapy, you need your X-ray or MRI, there’s no insurance company that you could tell you no.
If your doctor thinks that it’s medically necessary, you can go get your service done and no insurance company could deny your coverage.
The one thing that original Medicare does not include is dental, vision or hearing coverage. We would need a separate plan for that.
Then we have Medicare Advantage, which is actually an alternative to original Medicare A and B. This is called Part C of Medicare.
And most of these plans do have what’s called prior authorization for any kind of services.
And this is not a referral to see a specialist, but this is, oh, I need an MRI, x ray, physical therapy.
I would need to have it authorized by the insurance company.
That is one of the main differences between Medicare Advantage and original Medicare.
With the Medicare Advantage, we would have to have those services authorized before I can get my physical therapy performed.
Premiums vs. Out-Of-Pocket Costs
Medicare Advantage does have much lower premiums upfront, so you pay as you go with Medicare Advantage.
You pay much less out of pocket monthly.
But when you use the plans, you have a much higher out-of-pocket cost.
Medicare Advantage can also include some dental, vision, and hearing benefits, as well as some over-the-counter benefits, which is discounts at drugstores and cards where you can purchase drugstore items based on the insurance for free.
That is the main differences between the original Medicare and Medicare Advantage.
If you would like to discuss this – it’s extremely important to know the differences – feel free to reach out to us.
Feel free to call or text me at 201-357-7511 or call my office at (800) 650-9357.
My email is [email protected] as well.
If you’ve found this information helpful, consider following me on our social platforms: