Choosing Your Medicare Coverage: Medicare Advantage, Hospital Indemnity, or Medigap

Once you have Original Medicare Parts A & B you get to decide what you want to use as your coverage option.

Option 1 – Medicare Advantage

Option 2 – Medicare Advantage + Hospital Indemnity

Option 3 – Original Medicare + Medicare Supplement

Option 1: Medicare Advantage

Medicare Advantage, also known as Part C, is a plan that provides your healthcare coverage instead of using Original Medicare Parts A & B.

These plans are offered by private insurance companies approved by Medicare.

Many plans have a $0 or low monthly plan premium and may have a $0 medical deductible. Preventive services are generally covered at no cost when plan requirements are met, and plans typically have set copays or coinsurance for other medical services.

Most Medicare Advantage plans include Part D prescription drug coverage, and many also include dental, vision, and hearing benefits.

Medicare Advantage plans generally use provider networks, so it is important to make sure your preferred doctors, specialists, hospitals, and other facilities participate in the plan’s network.

Coverage, costs, provider networks, and benefits can change each year. Available plans should be reviewed annually, and there is an Annual Enrollment Period every year when you can change plans if another plan becomes the best option for your changing health care needs.

Option 2 – Medicare Advantage + Hospital Indemnity

This option combines the benefits of a Medicare Advantage plan with additional protection for some of the larger out-of-pocket costs you may have when receiving care.

A hospital indemnity policy can provide benefits for expenses associated with services such as inpatient hospital stays, ambulance services, emergency care, skilled nursing, outpatient surgery, and outpatient therapies. Depending on the policy selected, additional benefits such as cancer coverage may also be available.

The indemnity plan has an additional monthly premium. Depending on the specific policy, rates and benefits may be based on your age at enrollment.

This combination can provide additional financial protection from some of the larger copays and out-of-pocket costs associated with a Medicare Advantage plan.

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Not sure which Medicare option fits your needs?

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Option 3: Medicare Supplement (Medigap)

With this option, you keep Original Medicare Parts A & B as your primary insurance and add a Medicare Supplement (aka Medigap) plan

What does Original Medicare Cover?

What does a Medicare Supplement (Medigap) plan cover?

Medigap helps pay out-of-pocket costs left by Original Medicare, such as copayments, coinsurance, and deductibles.

With Plan G, after the annual Part B deductible is met, the plan covers the remaining Medicare-approved Part A and Part B cost-sharing included in Plan G.

There are no provider networks, allowing you to see any provider in the United States who accepts Medicare.

There are no prior authorizations.

• Medicare Supplements only provide medical coverage. Part D prescription coverage, dental, vision, and/or hearing coverage must be added separately.
• Medicare Supplements have a monthly premium. With a supplement, the monthly cost for most people includes:
  • Part B premium*
  • Medicare Supplement premium
  • Many people pay for a Part D plan
  • Optional dental, vision, and/or hearing coverage

All premiums can increase every year.

This generally makes Medicare Supplements the most expensive option in terms of monthly premiums. However, for many people they are still the best option if they do not want to be subject to provider networks and prior authorizations.

It is also important to understand that your Medicare Supplement Open Enrollment Period is a one-time, six-month period that generally begins when you are 65 or older and enrolled in Part B. During this period, you can purchase any Medigap policy available to you without being denied or charged more because of health problems. After this period, medical underwriting will apply.

So Which Do I Need?

Medicare Advantage vs. Medicare Supplement

Some people who qualify for certain state assistance programs may not have to pay the Part B premium. Contact Rachel to see if this may apply to you.

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