Medicare Supplement vs Advantage Plans

Medicare Supplement vs Advantage Plans

There are both negative and positive aspects to each type of Medicare plan.  This discussion of Medicare Supplement vs Advantage plans is intended to  help you understand those attributes so that you can effectively guide clients in selecting the plan type that best suits their needs.

Medicare Advantage

• Positive
  • Includes a part D drug plan (just as good as the stand alone ones you buy)
  • $0 to low premiums per month
  • Convenience- Medicare and drug on one card instead of using 3 cards
  • Extra benefits- include vision, dental and also, routine colonoscopy stays routine with some carriers
  • Enhanced annual physicals that cover more than Original Medicare does
• Negative
  • Network, some people do not like the idea
  • Copays can add up for those with a lot of medical needs
  • Referrals on some $0 premium plans
  • Prior Authorization can slow down access to procedures at times
  • Need to retain clients on an annual basis

Medicare Supplements

• Positive
  • No network-Provider only needs to take Original Medicare
  • Do not need prior authorization
  • No referrals and determine exact coverage level
  • Standardized benefits from one company to another
  • Easy to retain clients on an annual basis
  • Can change from one supplement to another 1^st of any month in CT or NY
• Negative
  • Premium for the supplement plan
  • Need to buy a drug plan and pay a 3^rd premium
  • Very limited preventative benefit
  • Will not cover services not approved by Medicare (Advantage plan will not either
  • Need to carry 3 cards (Original Medicare, Supplement and Rx plan)

Random Facts to Consider when deciding Supplement vs Advantage

• Use the Medicare Advantage Trial right to sell more
  • First time with an advantage when turning 65 or first time switching to an advantage plan (Good for 1 year)
    • Can move to a supplement and drug plan first of any month for first year
    • Be sure it is the first time client has had an Advantage Plan or it will not work.
  • Pre-existing condition clause on supplements if client is without coverage for 63 days prior to enrolling
  • A supplement will NOT term out an advantage plan and vice versa. Only a drug plan can do that.  Need to make your client aware.
  • Popular Supplements
    • Plan F =100% coverage
    • Plan G = 100% coverage after $198 part B deductible
    • Plan N= All covered except
      • $198 part B deductible
      • Up to $20 doc charge
      • ER copay of $65
    • High deductible F and G Plan
      • $1,340 deductible
      • Very good deal for client if they can understand it
      • Low comp for agent
    • Know  both the MSP rules for CT and also the EPIC rules and income levels. Eligible clients have a special election and can either change or enroll at anytime.

Crowe and Associates is appointed with all of the major Medicare companies, as well as many of the regional ones.    In fact, We offer our contracted agents full support.  CLICK HERE TO LEARN MORE ABOUT MEDICARE SALES.

CLICK HERE TO DOWNLOAD A CONTRACTING KIT.   Or, CLICK HERE TO CONTRACT ONLINE.