Many people get confused between a Medicare Supplement and a Medicare
Advantage policy. Many people think that they are the same thing, but they are not.
A Supplement Policy will pay AFTER Medicare. Depending on the plan that you have
chosen, it will pay the Part A Deductible (for the hospital) and possibly the Part B
Deductible (for the doctor). It may then pay the 20% that medicare does not pay, and
even possibly the extra 15% (Part B Excess Charges), if the doctor does not accept
"Assignment" (the allowable charge by Medicare). It may also cover other things such
as "Foreign Travel". When you have a Supplement, you can see any doctor or
hospital that accepts Medicare.
An Advantage Plan, is a contract that Medicare has with a private insurance
company to administer your benefits. It does not pay after Medicare, it pays INSTEAD
of Medicare. The premiums associated with Advantage Plans are generally lower
than that of a Supplement,
however, when you go see
a doctor or go to the hospital,
you will have co-payments.
There are different types of Advantage Plans. There are HMO's, PPO's and PFFS
(Private Fee for Service) plans. With HMO's, you are restricted to "in Network"
doctors, and will need to get "referrals" to go see a specialist. With a PFFS plan, you
can see any doctor or hospital that takes Medicare, as long as they agree to accept
it. They can accept a plan on a case by case basis. Advantage plans are mandated
to cover what Medicare covers, but they sometimes cover things at different rates.
Not every doctor or hospital that accepts Medicare, will accept an Advantage Plan,
so you must check before you sign up for anything. If you go to a doctor or hospital
that does not accept your plan, you will be responsible for the entire bill. Medicare
will not pay anything.
The best idea would be to meet with a professional who specializes in these
products, and see which plan would be best for your own circumstances.
David Hecker is a Licensed Insurance Agent based in Texas. He specializes in
Medicare Products. He is licensed in Texas, Louisiana and Arkansas. He can be
reached at (903) 918-9091 or Toll Free (877) 454-4959. E-mail:
email@example.com or on the web at:
What's the Difference Between a Texas Medicare Supplement and a Medicare Advantage Plan?
Written by David Hecker
|David Hecker * 3010 Latonia St. Longview TX 75605
Licensed in Texas, Louisiana & Arkansas
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* Not connected with or endorsed by the United States government or the federal Medicare program.