Medicare Supplement plans work with original Medicare to cover costs that Medicare does not, have standardized benefits across insurers, and allow freedom to see any doctor. Medicare Advantage plans are run by private insurers as alternatives to original Medicare, have networks of providers and varying benefits, and can be more limited than Medicare Supplement plans. It is important for enrollees to understand the differences between these options when deciding which type of coverage is best for their needs.

1. Medicare Supplement
vs
Medicare Advantage

2. What you
need to know

3. Medicare Supplement vs
Medicare Advantage
In 2013, Medicare
beneficiaries have two
basic options for
healthcare coverage.
Traditional Medicare and
supplemental insurance
(also known as Medigap)
policies and Medicare
Advantage policies.

4. Medicare Supplement vs
Medicare Advantage
It is important to note that
there is a significant
difference between
Medicare Advantage
plans and Medicare
Supplement insurance.

5. Medicare Supplement vs
Medicare Advantage
Learning about the
differences between
Medicare Advantage
plans and traditional
Medicare Supplement
insurance is essential when
deciding which coverage
is right for you.

6. Medicare Supplement vs
Medicare Advantage
Medicare Supplement plans:
 provide coverage for the
“gaps” of original
Medicare Parts A and B,
 were standardized in 1992,
 are carefully regulated to control
the quality of coverage, and
 work in conjunction with original
Medicare to provide healthcare
coverage

7. Medicare Supplement vs
Medicare Advantage
Medicare Advantage plans:
 a new name for Medicare+Choice
(M+C),
 are private healthcare plans
subsidized by Medicare,
 may take the form of an:
o HMO
(Health Maintenance
Organization),
o PFFS (Private Fee-For-Service)
plan, or
o PPO (Preferred Provider
Organization).

8. Medicare Supplement vs
Medicare Advantage
Medicare Supplement plans:
 are available through private
insurance companies,
 12 standardized policies –
Plans A through L,
 each plan offers varying levels of
coverage,
 benefits of each plan are the same
from any insurance company
across the industry.

9. Medicare Supplement vs
Medicare Advantage
Medicare Advantage plans:
 are available through private
insurance companies,
 unique to the company offering
them,
 usually take the form of “Basic” or
“Premium” plans,
 varying levels of coverage for
each plan,
 no two plans are alike,
 companies are encouraged to
compete for pricing and plans.

10. Medicare Supplement vs
Medicare Advantage
Medicare Supplement plans:
 enrollees may use the doctor or
hospital of their choice,
 almost all doctors and hospitals
across the United States accept
Medicare Supplement plans,
 beneficiaries may also travel the
United States with little worry of
coverage being available.

11. Medicare Supplement vs
Medicare Advantage
Medicare Advantage plans:
 enrollees may be restricted
to the use of certain doctors
and hospital selections in a
network of providers,
 only those approved providers
are covered in the event
of treatment.
For authorized agent use only. Not for public use.

12. Medicare Supplement vs
Medicare Advantage
Medicare Supplement plans:
 are guaranteed renewable,
 as long as premium payments
are made in a timely manner,
beneficiaries cannot be
denied coverage,
 laws are in place to provide
beneficiaries the ability to
seamlessly enroll with another
company, should the company
providing the supplemental policy
go out of business.
For authorized agent use only. Not for public use.

13. Medicare Supplement vs
Medicare Advantage
Medicare Advantage plans:
 must sign contracts with Medicare
to provide covered benefits,
 contracts are reviewed annually
and are subject to termination,
 if the contract is not renewed,
the plan may simply disenroll
its Medicare beneficiaries.
For authorized agent use only. Not for public use.

14. Medicare Supplement vs
Medicare Advantage
Medicare Supplement plans:
 the 12 plans available vary in
level of coverage and cost,
 because the plans are
standardized across the
industry, the level of coverage is
the same from any insurance
company across the industry.

15. Medicare Supplement vs
Medicare Advantage
Medicare Advantage plans:
 may charge little or no initial
premiums to their members,
 enrollees may frequently
be charged co-pays and
co-insurance for any number
of healthcare treatments.

16. Medicare Supplement vs
Medicare Advantage
Medicare Supplement plans:
 do not come with built-in
prescription drug coverage,
 seniors may shop private
companies for affordable
Medicare Part D Prescription
Drug Plans,
 different types of Part D plans
are available with varying
levels of cost and coverage.

17. Medicare Supplement vs
Medicare Advantage
Medicare Advantage plans:
 many come with prescription
drug coverage built-in,
 “Basic” plans usually have lower
levels of drug coverage,
 “Premium” plans usually have
higher levels of drug coverage.

18. Medicare Supplement vs
Medicare Advantage
The contrast between Medicare Supplement
plans and Medicare Advantage plans can be
extensive.
With so many choices available, it is
essential that potential enrollees be fully
informed of the differences between plans.