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Medigap With Medicare Advantage: A Medicare Customer Question

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(Related: Active Employee Coverage and Medicare Part B: Medicare Customer Inbox)

Some Medicare questions show that insurance and financial professionals still have an important role to play in helping consumers understand coverage basics.

Here’s one that suggests how many opportunities the industry still has to reach out.

The Question

How will Medigap work with my Medicare Advantage plan?

The Answer

There are four parts of Medicare. You would not need to have a Medigap policy and a Medicare Advantage plan at the same time.

Traditional Medicare Part A and B cover hospital services, and outpatient and physician services.

Many Medicare beneficiaries decide to get additional coverage to fill the gaps in traditional coverage and cover prescription drug coverage.

Medicare Advantage, or Part C, is a “bundle” plan, and works like an employer plan. It bundles hospital, medical and drug coverage and replaces your 80/20 coverage from traditional Medicare Parts A & B. These plans can range from $0 to a couple hundred dollars for the premium; then you pay co-pays for each service you use.

Medigap, or Medicare supplement insurance, is a supplement to traditional Medicare A & B and helps pay for the 20% that traditional Medicare Parts A&B do not cover. These premiums tend to be higher cost than a Medicare Advantage plan, but you have less out of pocket costs.

There are plans that allow you to pay a higher premium, to arrange so that you only have to cover a small deductible before the plan pays everything else 100%. If you chose to get a Medigap policy, you may want to pick up a Prescription drug plan, or Part D, to help cover your drug costs. These plans typically have lower premiums and you pay co-pays or co-insurance when you fill medications.

The advantage of choosing to fully go onto Medicare is you can pick the path that works best for you based how you want to pay and then pick a plan that works well based on your needs.

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Bethany CissellBethany Cissell is a health care insurance services specialist at Allsup.