Medicare changes every year. In this video, we go over what changes you can expect to see in 2021.

Part A is your inpatient coverage. Most beneficiaries don't need to pay a premium for Part A because they've paid in for at least 40 quarters. Yet, if you didn't pay in at all, your Part A premium is $471. If you paid in for at least 30 quarters, your Part A premium in 2021 will be $259.

Part A also comes with a deductible. For 2021, the Part A deductible is $1,484.

If you end up in the hospital for an extended period of time, Part A will pay 100% of the cost of your stay for the first 60 days. After the first 60 days, your daily coinsurance will be $371 and for days 91 through 150, it will be $742 per day.

Skilled nursing facility coverage also falls under Part A. For the first 20 days, Part A will cover 100% of the skilled nursing facility's cost. For days 21 through 100, you pay a daily coinsurance of $185.50. After 100 days, you're responsible for 100% of the cost.

Next, Part B is your outpatient coverage. This comes with a standard deductible of $148.50 for 2021. Higher-income earners are subject to higher premiums. The Part B annual deductible for 2021 is $203.

Medicare Advantage also comes with cost-sharing. The average monthly premium for an Advantage plan in 2021 is $21, which is the lowest it's been since 2007.

Advantage plans come with a maximum out-of-pocket limit. This limit for 2021 is $7,550 for in-network and $11,300 for out-of-network.

Another change for 2021 is Advantage plans now accepting patients with End-Stage Renal Disease (ESRD). Additionally, some Advantage carriers will start including long-term care benefits, such as personal care, transportation, meal delivery, and adult day care services. Yet, benefits will still not cover room and board or help with daily living activities.

For Part D, the average monthly premium for 2021 is $41. Premiums vary from state to state. The 2021 Part D deductible is $445.

The last thing we'll go over today is Medigap changes for 2021. Medigap includes two high-deductible plans. The high deductible for both High Deductible Plan G and High Deductible Plan F is $2,370 for 2021.

Medigap also includes two plans with maximum out-of-pocket limits. The maximum out-of-pocket for Plan L is $3,110, and the maximum out-of-pocket for Plan K is $6,220.

It's important to remember that most, if not all, of the cost-sharing for Parts A and B will be covered by a Medigap plan if you have one.

2021 Medicare Changes - https://www.medicarefaq.com/faqs/medicare-changes-in-2021/
Part A - https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-a/
Part B - https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-b/

If you find the different enrollment periods within Medicare confusing, don't go anywhere. In today's video, we'll go over every part of Medicare and the enrollment periods that come with each.

My name is Lindsay Engle, and I'm the Medicare expert for Elite Insurance Partners and MedicareFAQ.com.

Medicare comes with many different parts and plans. Each one has a specific enrollment period, and some have multiple. In this video, I discuss which enrollment periods fall under each part.

First, we'll discuss Part A and Part B. Part A is your inpatient coverage, and Part B is your outpatient coverage. These parts come with two different enrollment periods:
• Initial Enrollment Period: When you can first enroll in Parts A and B. Begins 3 months before your 65th birthday, lasts the month of, and continues 3 months after your 65th birthday
• General Enrollment Period: If you miss your Initial Enrollment Period, this is the next time you can enroll in Parts A and B.  It occurs annually between January 1 and March 31. Your coverage will start on July 1
– If you have a change of circumstance, you can qualify for a Special Election Period (example: having creditable group coverage through your employer)

Next, we'll discuss the different enrollment periods that come along with Medicare Advantage plans.
• Initial Coverage Election Period (ICEP): Begins three months before your 65th birthday and when it ends is dependent on when your Part B becomes effective
• Annual Enrollment Period: If you miss your ICEP, the next time you can enroll is during the Annual Enrollment Period (AEP), which occurs each year between October 15 and December 7
• Medicare Advantage Open Enrollment Period: If you're enrolled in an Advantage plan, and you want to make changes, you can do so annually between January 1 and March 31
– You could also qualify for a Special Election Period due to a change in circumstance

Part D prescription drug coverage also comes with similar enrollment periods.
• Initial Enrollment Period: During this time, you can also sign up for Part D
• Annual Enrollment Period: If you miss your Initial Enrollment Period, the next time you can enroll is during the Annual Enrollment Period
– You can also qualify for a Special Election Period, just like Parts A, B, and C (Advantage)

Now, let's go over when you can enroll in a Medigap plan.
• Medigap Enrollment Period: This is your only enrollment period for Medigap. It lasts six months and begins once you enroll in Part B – it isn't annual like the others
– Outside of the Open Enrollment Period, you can enroll in a Medigap plan at any time of the year as long as you have Part B – the only difference is you will have to answer health questions

A common misconception is that you can enroll in a Medigap plan during the Annual Enrollment Period without having to answer any health questions. This is not true unless it overlaps with your Medigap Open Enrollment Period.

The last enrollment period we'll go over today is for those eligible for Medicare due to a disability.
Initial Enrollment Period: You become eligible for Medicare once you collect Social Security Disability Income for 24 months. After 24 months, your Initial Enrollment Period will begin. This is the same 7-month window we discussed at the beginning of the video
Second Initial Enrollment Period: In addition to your Initial Enrollment Period, you get a second one when you age in at 65

Thank you so much for watching! If you'd like more information on the different enrollment periods mentioned, make sure to check out our enrollment period playlist.

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If you're aging into Medicare, don't go anywhere. In today's video, we're going to talk about your Initial Enrollment Period.

Medicare comes with many different enrollment periods. It's important to understand the difference between each one. Your Initial Enrollment Period is the first window of opportunity you have to enroll in Parts A and B, as well as Part D.

Your Initial Enrollment Period is a seven-month window. It begins three months before your 65th birthday, lasts the month of your birthday, and will continue three months after your birthday. If your birthday happens to fall on the first of the month then your IEP will begin the month before your 65th birthday. For example, if your birthday is on July 1, your IEP begins on March 1, and your coverage will become effective on June 1.

It's important to know that your Initial Enrollment Period only comes around once in your lifetime. The only exception is for those collecting Social Security Disability Income, in which case, your IEP comes around twice. Your first IEP will begin 24 months after you first collect SSDI. When you turn 65, you will have another IEP.

During this window, you can enroll in Original Medicare (Parts A and B) and Part D. When you enroll during your IEP,  you can avoid the late penalties that come with Part B and Part D when you don't have creditable coverage. You can also enroll in a Medicare Advantage plan during this window because your Initial Coverage Election Period for Advantage is also a seven-month window beginning six months before your 65th birthday and ending the last month before you enroll in Part B or the last month of your Initial Enrollment Period.

When it comes to Medicare Supplements, your Initial Enrollment Period is important because it will activate your Medicare Supplement Open Enrolment Period once you enroll in Part B. When you enroll in Part B, your six-month window to enroll in a Medicare Supplement plan without having to answer any health questions will begin.

If you're collecting Social Security Income before turning 65, you'll be automatically enrolled in Part A and Part B when you age in. If you're not collecting Social Security by age 65, then you'll need to actively enroll in Parts A and B.

If you work for an employer with fewer than 20 employees, have retiree insurance, or TRICARE, you'll want to take advantage of your IEP and enroll in Parts A and B. This is because your Medicare becomes primary and your other coverage becomes secondary. If you don't enroll in Parts A and B when you're first eligible, you could be subject to paying 80% of your medical costs out-of-pocket.

If you work for an employer with more than 20 employees, your employer coverage becomes primary. At this time, you'll have the option to enroll in Part A or B without penalties if you delay coverage.

Since Part A is premium-free for most, the majority of people choose to enroll in it. You can choose to delay enrolling in Parts B and D since your employer group coverage is considered creditable and you'll get a Special Enrollment Period when you leave it.

Now, if you happen to miss your IEP, you will have to wait until the General Enrollment Period to enroll in Parts A and B. This occurs annually between January 1 and March 31. However, your coverage won't begin until July 1. This could leave you with a gap in coverage. If you went more than 12 months after your IEP, you could start incurring penalties if you didn't have creditable coverage.

If you didn't enroll in a Part D plan during your IEP, the next opportunity you have is the Annual Enrollment Period. This enrollment period occurs each year between October 15 and December 7.

Youtube Video : https://youtu.be/ez15SApv8aE

If you're a Medicare beneficiary living in Massachusetts, don't go anywhere. We're going to discuss how Medigap plans work in Massachusetts.

I'm Lindsay Engle, the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com. Original Medicare comes with many out-of-pocket costs in the form of cost-sharing. Most people enroll in a Medigap plan to help with these gaps in coverage.

Medigap plans are standardized by the federal government. All 50 states – except for three – follow these standardized plans. Typically, you have 12 options to choose from, but in Massachusetts, you have three.

Your three options in Massachusetts are the Core Plan, Supplement1 Plan, and 1A Plan. The 12 plans that are standardized by the federal government are labeled Plans A through N.

The Core Plan in Massachusetts follows Medigap Plan A. The core plan will cover coinsurance that falls under Part A for an additional 365 days after your Original Medicare benefits have been exhausted. Also, it will cover any coinsurance under Part A for hospice care.

Additionally, the Core Plan will cover any coinsurance under Part B. It will also cover the first three pints of blood if needed at a hospital or doctor's office and an additional 60 days of inpatient mental health care.

Basically, the Core Plan covers your core benefits only.

The next plan option you have is Supplement1 Plan. This plan is in line with Plan F. It pretty much covers all of your monthly expenses outside your monthly premium.

Supplement1 Plan includes the same benefits as the Core Plan. It covers your Part A and Part B deductible, any coinsurance at a skilled nursing facility, foreign travel emergency care, and an additional 120 days of mental healthcare at an inpatient facility.

It's important to include that if you're eligible for Medicare after 2020, you won't be eligible for the Supplement1 Plan. This is because it covers the Part B deductible, which makes it a first-dollar coverage plan. As of 2020, all first-dollar coverage plans will be unavailable to newer Medicare beneficiaries.

If you're eligible after 2020, you can enroll in the Core Plan or the 1A Plan. If you're eligible for Medicare prior to 2020, you can enroll in any of the three options.

The last plan you have to choose from is the 1A Plan. This plan is very similar to Plan G. It covers the same benefits as the Core Plan, and the same benefits of the Supplment1 Plan, minus the Part B deductible.

To summarize, if you're a Massachusetts resident, you have only three Medicare Supplement options from which to choose. The Core Plan includes the core policy benefits that you'll see under Plan A. The Supplement1 Plan basically covers the same benefits as Plan F. Finally, the 1A Plan covers the same benefits as Plan G.

For more information on Massachusetts Medigap plans: https://www.medicarefaq.com/medicare-supplements/medigap-by-state/massachusetts-medigap-plans/
PDF documents of all 3 plans: https://www.medicarefaq.com/medicare-supplement-outline-of-coverages/ma-medicare-supplement-outline-of-coverage.pdf

I hope you found this video helpful! If you did, make sure to subscribe to our YouTube channel. Don't forget to turn notifications on, so you know as soon as we upload a new video. If you have any questions, make sure to leave them in the comments section below.

Facebook Community: https://www.facebook.com/groups/MedicareFAQ/

Are you new to Medicare and considering delaying enrollment in Part D? Don't go anywhere – in this video, we explain how the Part D penalty works.

My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com.

Part D works as prescription drug coverage alongside Parts A and B. The best time to enroll is when you're first eligible, during your Initial Enrollment Period.

Your Initial Enrollment Period begins three months before your 65th birthday. Will be the month of, and continues for three months after your 65th birthday. This gives you a seven-month window to enroll.

Like Parts A and B,  Part D comes with a late penalty if you delay enrolling without creditable coverage. If you don't have creditable coverage, you may qualify for a Special Election Period to eliminate this penalty.

This penalty works differently from the Original Medicare penalties. With Part D, you'll be charged a penalty equal to 1% of the national average premium for every month you delayed enrolling without creditable coverage.

You'll pay this penalty every month as long as you have Part D coverage. If you're penalized, you can appeal the penalty by submitting a reconsideration request. This is available on CMS's website.

For example, say you waited 33 months after your Initial Enrollment Period to enroll in a Part D plan. Unless you had creditable coverage or qualify for a Special Election Period, you'd be charged 1% of the national average Part D premium for each of those 33 months.

Currently, the average premium for Part D is $33.06. The penalty is calculated by multiplying $33.06 by 0.33 (33 months), which equals $10.90. The Part D penalty is rounded to the nearest 10 cents. Therefore, your Part D premium would be somewhere around $43.97. Your premium would continue to increase, as the average premium does each year.

Each Part D carrier sets its premium and drug formulary. Even if you think you don't need Part D prescription drug coverage right now, many different carriers offer these plans nationally. The monthly premiums start at around $15.

When choosing between paying the premium now and paying the penalty for the rest of your life, it makes more sense to enroll sooner. This way, you'll avoid the penalty.

Part D plans change annually. Each September, you'll receive an Annual Notice of Change letter that will go over your drug formulary and notify you of any premium increases.

During the fall Annual Enrollment Period from October 15 through December 7, you'll have the opportunity to compare other plans in your area and make sure you have the lowest premium available.

As has been noted, the best time to enroll in a Part D plan, and avoid penalties, is during your Initial Enrollment Period.

Part D: https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-d/
Part D Late Enrollment Penalty: https://www.medicarefaq.com/faqs/medicare-part-d-late-enrollment-penalty/
Initial Enrollment Period: https://www.medicarefaq.com/faqs/medicare-initial-enrollment-period/
Special Election Period: https://www.medicarefaq.com/faqs/medicare-special-enrollment-periods/
Annual Enrollment Period/Open Enrollment Period: https://www.medicarefaq.com/faqs/fall-medicare-open-enrollment-period/

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#MedicarePartD #LateEnrollmentPenalty #PrescriptionDrugPlan

If you're considering delaying enrollment into Original Medicare Parts A and B, don't go anywhere. In this video, we'll go over what you need to know about Medicare's late enrollment penalties.

My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com. When you first become eligible for Medicare, you may consider delaying enrollment. However, there are penalties associated with delaying enrollment in Medicare. We're here to explain what they are and how to avoid them.

Part A is your inpatient or hospital coverage. Most people are entitled to premium-free Part A, as long as they paid into enough quarters while still working. The late enrollment penalty for Part A is 10% of the current Part A premium. You'll pay this for twice the number of years you were eligible but didn't enroll.

For example, if you were eligible for two years but never signed up, you would have to pay 10% above the standard premium for four years.

Part B is your outpatient or doctor's coverage. The Part B penalty is 10% above the standard premium for every 12 months you went without coverage. Unlike Part A penalty, the Part B penalty is lifelong. The only way around it is if you're eligible for a Special Enrollment Period.

An example of the Part B penalty is if you were eligible for coverage in November 2013 but chose not to enroll until March 2017. This would mean you delayed enrolling for 40 months, or three years and five months. This time would count as three full 12-month periods, meaning you would have to pay a late enrollment penalty for 30% above the standard premium.

Now, how do you avoid both of these penalties? To avoid the Part A and Part B penalties, you'll want to enroll when you're first eligible; during your Initial Enrollment Period.

Your Initial Enrollment Period starts three months before the month of your birthday includes the month of your birthday, and continues three months after. Once you miss your seven-month IEP, you may begin to incur penalties, unless you're eligible for a Special Enrollment Period.

The majority of beneficiaries choose to enroll in Part A because it's premium-free for most. The most common reason for delaying Part B is if you have group employer coverage and your employer has more than 20 employees. In this case, the coverage is considered creditable, and you can delay enrollment into Part B with no penalty.

One of the most common questions we receive is if there's a cap on the Part B penalty. Unfortunately, at this time, there is no cap.

Another thing to note is if you're eligible for Medicare due to a disability and were paying penalties on your premiums, the premiums will be eliminated once you turn 65.

If you feel that the penalties you have incurred shouldn't have applied to you, you can submit a reconsideration request to Medicare. [LINK HERE]

I hope you found this video helpful! If you did, don't forget to subscribe to our YouTube channel. Turn notifications on so you'll know as soon as we upload a new video.

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Are you aging into Medicare and still working? Don't go anywhere! In this video, we explain how your employer coverage works with Medicare. My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com. The size of your employer will be a factor in your Medicare decision when you're 65 years old and still working.

If Your Employer Has 20+ Employees:
If your employer has more than 20 employees, your employer coverage becomes primary, and Medicare becomes secondary. In this scenario, most beneficiaries choose to enroll in Part A because Part A is usually premium-free as long as you have paid into Medicare for sufficient quarters. If you end up at the hospital, your Part A benefits will help keep your out-of-pocket cost lower.

Part B is your outpatient coverage, and Part D is your prescription drug coverage. As long as your employer has more than 20 employees, the coverage is considered creditable under Medicare. This allows you to delay enrolling in Part B and Part D without being penalized.

Because employer group coverage usually includes outpatient services and prescription drug coverage, most beneficiaries choose to delay enrolling since each comes with a monthly premium. Down the road, when you retire, you'll qualify for a Special Election Period. You'll be able to enroll in both Part B and Part D without incurring any penalties. 

If Your Employer Has Fewer Than 20 Employees:
If your employer has fewer than 20 employees, your Medicare becomes primary, and employer coverage is secondary. In this scenario, you'll want to enroll in both Part A and Part B. If you don't, you could be responsible for paying 80% of your outpatient services as well as incur a late penalty.

An Exception:
If you have a high-deductible plan and health savings account, and you plan to continue contributing or accepting your employer's contributions, you shouldn't enroll in any parts of Medicare. This is because the IRS states that if you have any additional coverage, including Part A, you cannot continue contributing to your HSA.

Important Tips:
• It's important to make sure your employer notifies Medicare that you  have retired to avoid rejection of any of your medical bills
• If you're currently collecting Social Security Income, you will automatically be enrolled in Part A. You cannot collect SSI without also enrolling in Part A.

If you plan to continue working past 65 and delay retirement, I hope you found this video helpful. If you did, make sure to subscribe to our YouTube Channel! Turn notifications on, so you know as soon as we upload a new video.

Medicare and Employer Coverage FAQ: https://www.medicarefaq.com/faqs/medicare-and-employer-coverage/
Medicare & HSA: https://www.medicarefaq.com/faqs/hsa-and-medicare/
Our Medicare Facebook Community: https://www.facebook.com/groups/MedicareFAQ/

#Medicare #Turning65 #EmployerGroupCoverage

If you're a California resident who is eligible for Medicare, don't go anywhere! We're telling you what you need to know about Medicare Supplements in California and explain in detail how the Birthday Rule works.

Once you become eligible for Medicare, you'll have the option to enroll in supplemental coverage. This supplemental coverage comes in the form of either a Medicare Advantage plan or a Medigap plan with an additional Part D drug plan.

You can enroll in a Medicare Advantage plan during your Initial Coverage Election Period. If you missed your Initial Coverage Election Period, you could enroll during the Annual Election Period that comes around each October. If you enroll in a Medigap plan instead, your first opportunity to do so is during your Medicare Supplement Open Enrollment Period.

If you miss your Open Enrollment Period, you can still enroll in a Medigap plan at any time of the year. However, you'll have to go through medical underwriting and answer health questions.

Good news: if you're a California resident and want to change Medigap plans, you'll have an additional opportunity to do so without answering any health questions. The California Birthday Rule says that each year, 30 days before your birthday and 60 days after your birthday, you'll have the option to change your Medigap plan without answering health questions.

You're allowed to switch plan carriers, keeping the same plan with the same benefits, or switch to a plan with fewer benefits. For example, if you have Plan F, you can enroll in a different Plan F with another carrier. Alternatively, you can enroll in Plan G.

As another example, if you have Plan G, you can enroll in Plan G with a different carrier or enroll in Plan N. However, you won't be able to enroll in Plan F since Plan F has more benefits than Plan G.

Your premiums can increase year over year, so California residents benefit from the Birthday Rule. It allows you to shop other rates in your area to see if you can find one that's more affordable. If your health declines, you won't have to worry about that impacting your rates.

You can apply for Original Medicare (Parts A and B) in California, online, via telephone, or at your local Social Security office.

If you're ready to enroll in a Supplemental Medicare plan in California, give us a call! Once an agent collects some information from you, they'll be able to compare all your Medigap options for your area.

Medigap in California: https://www.medicarefaq.com/medicare-supplements/medigap-by-state/california-medigap-plans/

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If you're not sure which Medicare Supplement plan to enroll in, don't go anywhere! Today, we're going to review the top Medicare Supplement plans.

Hi everyone, my name is Lindsay Engle. I'm the Medicare expert for Elite Insurance Partners and MedicareFAQ.com.

The top Medicare Supplement plans include Plan F, Plan G, and Plan N.

First, we'll talk about Plan F. Medicare Supplement Plan F is one of the most popular plans due to it leaving you with zero out-of-pocket costs outside of your monthly premium. Plan F is considered first-dollar coverage. This means that when you go to the doctor or the hospital, you'll never have to pay any copays, coinsurance, or deductibles. It's important to remember, though, that more benefits come with a higher monthly premium. So, Plan F is one of the more expensive plans because it includes the most benefits.

Plan F is only available to those eligible for Medicare prior to 2020. Regardless of if you have enrolled in Part B and a Medigap plan already, you are still eligible to enroll in Plan F. Those who were not eligible to enroll in Medicare before 2020 are not eligible to enroll in Plan F.

The runner-up plan to Plan F is Plan G. If you are not eligible for Medicare until after 2020, Plan G is the plan with the most benefits you are eligible for. Plan G covers all the same things as Plan F. The only difference is the Part B deductible. So, when you go to the doctor's office, you'll be responsible for paying the Part B deductible. Once you've met the Part B deductible, your benefits will kick in at 100% and you'll have no additional out-of-pocket costs.

Last but not least on our top Medigap plan list is Plan N. With Plan N, you'll still be responsible for the Part B deductible. In addition, you'll be responsible for a $20 copay at the doctor's office and a $50 copay at the emergency room. These copays keep your monthly premium lower. The only other out-of-pocket cost you'll be responsible for with Plan N is in the form of excess charges. The majority of beneficiaries don't need to worry about excess charges. To learn more about excess charges, read our article below.

That about wraps it up! We hope you found this video on the top Medigap plans helpful. If you did, make sure to subscribe to our YouTube channel. Don't forget to turn notifications on so that you're notified every time we upload a new video. We also have a fantastic Medicare Community on Facebook. Click the link below to join!

https://www.facebook.com/groups/MedicareFAQ

Medicare beneficiaries have the option to obtain additional coverage that will supplement their original Medicare benefits. You can choose between a Medicare Advantage plan or a Medicare Supplement plan. Today, we will compare both side-by-side, so you can make the best decision for your health care coverage.

When you enroll in Medicare, you have the option to enroll in Part A and Part B. Part A is your hospital coverage and Part B is your doctor's coverage, or medical coverage.

There are still many out-of-pocket costs when it comes to Part A and Part B. This includes deductibles and coinsurance. In order to fill in the gaps of coverage that original Medicare doesn't include, you'll need to enroll in supplemental coverage. For this, you have two options. Option 1: a Part D plan with a Medigap plan, or Option 2: a Medicare Advantage plan.

If you are enrolling in a Medigap plan, it is recommended to add a stand-alone Part D plan because Original Medicare does not include prescription drug coverage. Medicare Supplement (Medigap) plans cover additional, out-of-pocket costs you are otherwise responsible for, such as coinsurance and deductibles.

The second option you have is to enroll in a Medicare Advantage plan. Medicare Advantage is not the same as Original Medicare. Medicare Advantage plans are managed healthcare plans offered through private insurance companies.

Medicare Advantage plans tend to have lower monthly premiums when compared to Medigap. Some Medicare Advantage plans come with ancillary benefits like dental and vision. Some also include prescription drug coverage. Due to the low or $0 monthly premium, beneficiaries need to pay more out-of-pocket as they use the benefits.

You may be wondering, how are Medicare Advantage plans free?! The Medicare Advantage carrier is paid around $1,000 per month by Medicare to take on your risk. That is how they are able to offer such low premiums, including some $0 monthly premiums.

In addition, Medicare Advantage carriers make money from cost-sharing. Unlike Medigap, you'll have copays every time you see a doctor. If you see multiple doctors within one visit, you could have just as many copays to pay in one exam.

It is also important to know that you still have to pay your monthly Part B premium with a Medicare Advantage Plan. A common misconception is that you don't have to pay the monthly Part B premium. This is not true and you will still be responsible for it.

You see many Medicare Advantage commercials throughout the year, especially during the Annual Enrollment Period. This is because carriers want these policies to seem more attractive to you with their $0 premiums and additional benefits. This makes them seem like all-inclusive plans. Keep in mind, however, that they are paid by Medicare to take on your risk and they will make their money between Medicare and cost-sharing you pay out of pocket when you use those benefits.

Medicare Advantage Plans need to cover the same benefits as Original Medicare. However, it is up to the carrier how much they will cover for that specific service. While Medicare may pay 80% for your doctor visit, Medicare Advantage might cover less than that as well as throw on additional cost-sharing in the form of copayments and coinsurance. All of this can quickly add up to more than the premium would have been for a Medigap plan.

So, is it better to have a Medicare Advantage plan or a Medigap plan? This depends on your specific situation. One may not be better than the other. However, one might be better than the other for you.

Three Things to Consider When Deciding Which Plan to Go With:

1. Budget
2. Medical Usage
3. Travel Frequency

The last thing you should keep in mind is that if you enroll in a Medicare Advantage plan, you may not be able to enroll in a Medigap plan in the future.