Comparing Medicare Plans
Comparing Medicare plans can be confusing. If you’re looking at Medicare options without the help of an agent, keep the following things in mind when comparing your options. Talk to one of our advisors if you have any questions.
Coverage vs. Budget
When you are deciding between Medicare Advantage and Medicare Supplements, remember that you will trade cost for coverage. Medicare Advantage is usually less expensive, but has higher out of pocket costs. Medicare Supplements are usually more expensive, but have lower out of pocket costs.
Medicare Advantage usually has a copay or coinsurance for patients, while Medicare Supplements may cover all copays and coinsurances.
Network/Provider Choice
Medicare Advantage plans require use of resources within their network. Medicare Advantage plans differ on the types of network they have to provide coverage, including HMO and PPO options.
Medicare Supplements do not have the same restrictions, and these plans can be used by any provider that takes Medicare nation-wide.
Other Benefits
Many Medicare Advantage plans offer extra benefits like routine dental care, prescription drug coverage, and routine hearing care. Some Medicare Advantage plans may also offer extra benefits such as:
- Safety devices for the home that reduce the risk of injury, including bathroom safety devices or personal emergency response systems
- Transportation to health-related services, such as the doctor’s office or pharmacy
- Emergency care coverage outside the country
- Over-the counter medications
- Adult day-care services
Medicare Advantage plans may also offer a range of extra benefits for members with certain chronic health conditions, including personal care services like housekeeping, dressing, and home delivery meal services.
Some Medicare Advantage plans also offer membership in SilverSneakers, which is a popular exercise program for older adults. Membership provides access to more than 15,000 participating locations nationwide, including gyms, wellness centers, and YMCAs.
Star Ratings
Medicare uses a Star Rating System to measure how well Medicare Advantage plans perform.
Remember: Before considering a plan’s star rating, make sure the plan’s coverage and costs suit your needs.
You can use the overall star rating to compare performance among several different plans. Medicare reviews plan performance yearly and releases new star ratings each fall. This means plan ratings may change from year to year.
Medicare Advantage Plans are rated on how well they perform in five different categories:
- Staying healthy: screenings, tests, and vaccines
- Managing chronic (long-term) conditions
- Plan responsiveness and care
- Member complaints, problems getting services, and choosing to leave the plan
- Health plan customer service
Conclusion
Every person’s situation is different, so take the time to look at the comparison chart for more information.
Comparison Chart
| Medicare Advantage | Medicare Supplement | |
| Can make changes | Two open enrollment periods per year | One period per lifetime unless there are special circumstances |
| Monthly premium | As low as $0 | Usually has a monthly premium |
| Part B deductible | May not have a deductible | Must pay unless you got Plan C or F before January 1, 2020 |
| Part B premium | Must pay | Must pay |
| Prescription drugs | Generally covers | Does not cover |
| Routine dental, routine hearing, routine vision | May cover | Does not cover |
| Networks that restrict providers | Yes | No |
| Standardized benefits | No | Yes |
| Copayments and coinsurance | Usually has copayments and coinsurance | May cover all copayments and coinsurance |
Reach out to one of our local advisors for a personal consultation to compare Medicare plans. Our advisors are here to help you make the best decision for your individual situation. Call (801) 901-3519 or visit our site HERE.
