Fact & Fiction in Medicare: Here’s What You Need to Know to Find the Best Coverage

November 29, 2016

Turning 65 next year? Don’t wait for your birthday to start researching your Medicare options. With all the plans and parts, it can seem like swimming through an alphabet soup (Part A, Part B, Part C and on and on). You can more successfully navigate the world of Medicare by starting your research in advance. To help you along the way, we’re dispelling and confirming a few myths and truths about Medicare.

A Medicare Advantage Plan (Part C) is better than Medicare Supplement Insurance.

FALSE Neither program is better than the other is. Rather, the plan that’s best for you will depend on your personal health and financial situation. Here are two questions to consider when evaluating whether Medicare Supplement Insurance (or MedSup as it’s also called) or the Medicare Advantage plan is best for you.

  • Would you rather pay a higher monthly premium but less when you visit the doctor, or a lower monthly premium and higher co-insurance or deductibles? MedSup programs often have higher monthly premiums than the Medicare Advantage, but the co-insurance and deductibles can be more expensive with a Medicare Advantage plan.
  • Do you have preferred doctors or are you open to see any practitioners? With Medicare Advantage, you’ll see a specific group of providers, but you can choose your doctors with a MedSup plan.

You can switch from a Medicare Advantage Plan to a MedSup program.

TRUE If you sign up for a Medicare Advantage Plan first but decide to switch to a MedSup, you can do so during Medicare open enrollment, but you’ll have to go through medical underwriting. That means the insurance provider who oversees the MedSup program will evaluate your overall health and medical condition. After a successful medical underwriting, you’ll be able to sign up for the MedSup plan.

I’ll never be dropped from my Medicare Advantage Plan.

FALSE Your Medicare Advantage Plan can be cancelled at the end of the year. If that occurs, you’ll be offered an option to sign up for a MedSup program. Your annual premiums for a MedSup program may increase from year to year, but you cannot be dropped from the plan as long as you pay your premiums. It’s important to note, though, that if you have to sign up for MedSup because you were cancelled from a Medicare Advantage Plan, you may only be offered certain plans. Your options will vary by state and by insurance provider.

MedSup plans are the same across companies.

TRUE These plans are standardized by the government, so a MedSup plan G from one provider will offer the same coverage as the same plan from another provider. That makes it easier for you and your insurance agent to compare plans and determine what’s most affordable for you.

All Medicare prescription drug plans are the same.

FALSE While the government regulates MedSup plans, prescription drug plans are not controlled in the same manner. Private insurance companies oversee these programs, and their rates change often in how they’ve set up price tiers for prescription drugs. Depending on the plan in which you’re enrolled, you could save hundreds, or even thousands, of dollars each year by switching to a new drug plan.

As you can see there are many variables with Medicare and an experienced health insurance broker, like those at Long & Foster Insurance, can help you navigate through the process and get the best coverage for your needs.