FAQs

Will I still have Medicare if I enroll in a Medicare Advantage Plan?

Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans (Part C). These companies must follow rules set by Medicare. A Medicare Advantage Plan is another way to get your Medicare Part A and Part B coverage. If you choose to enroll in a Medicare Advantage Plan, you'll still have Medicare, but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. You will present your plan insurance card to providers and not your Medicare Card.

Medicare Advantage vs Medicare Supplement- What are the differences?

No matter which type of Medicare plan you choose, you must continue to pay your Part B premium. If you’re one of the few people who pay for Part A, you’ll have to continue paying that premium as well.

Premiums:

You pay a separate monthly premium for Medicare Supplement plans. The cost of your premium depends on the plan you choose, your age, location, sex, and other factors. Premiums typically range between $50 and $250 a month and often increase in price as you get older. Does not include Part D coverage.

Some Medicare Advantage plans have a monthly premium, but most people choose a $0 premium plan. Among those who do pay a premium, the average cost is $25 a month, which usually includes Part D coverage.

Deductibles:

You don’t have an annual deductible with Medicare Supplement plans unless you choose a high-deductible plan. Most Medicare Supplement plans pay your Part A deductible and coinsurance and 100% of your Part B costs after you meet the Part B deductible. if you choose a high-deductible plan, your plan pays 100% of your costs after you pay $2,340 out-of-pocket.

Medicare Advantage Plans may or may not have an annual deductible, but most people have access to a $0 deductible plan. Some plans have a separate deductible for Part D.

Cost Sharing:

There is no cost sharing with most Medicare Supplement plans. This means the plans pay 100% of your Part A inpatient and Part B coinsurance. If you choose Plan N, you pay a small copayment at the time of service. The copay is usually $20 or less for doctor visits and $50 or less for emergency room care.

You usually pay a flat copayment for health care with Medicare Advantage plans. A typical HMO plan might charge $5 for primary care visits, $25 for specialist care, and $50 for urgent care and emergency room visit.

Out of pocket maximum:

Out-of-pocket limits only apply to two Medicare Supplement plans: Plan K and Plan L. These two plans pay between 50% and 75% of your Part A and Part B coinsurance until you reach the out-of-pocket maximum. After that, they cover 100% of your costs. In 2021, the out-of-pocket maximums for Plan K and Plan L are $6,220 and $3,110, respectively.

All Medicare Advantage Plans have an out-of-pocket limit. Once you reach it, your plan pays 100% of covered costs. Medicare sets the maximum limit each year, but most plans set their maximum below Medicare’s limit. In 2021, the average Medicare Advantage out-of-pocket maximum is about $5,091.

Additional Benefits:

Most Medicare Supplement Plans do not include any extra benefits, although a few offer SilverSneakers or a similar fitness membership. You may be able to buy vision and dental coverage for a separate monthly premium. Very few plans include vision and dental benefits in the monthly premium. No Medicare Supplement plans include Part D, although most companies that sell Medigap plans also sell Part D.

Most Medicare Advantage plans include Part D coverage for prescription drugs. A majority also include SilverSneakers, as well as benefits for routine vision, dental, and hearing care. Some plans include new expanded benefits. The most common are allowances for over-the-counter medications and devices, home meal and grocery delivery, and non-medical transportation. There is no extra cost for these benefits.

Flexibility:

If you like to travel or spend part of the year in another state, you need the flexibility to get health care no matter where you are. Most Medicare Advantage plans require you to use an approved provider network. On the other hand, a Medicare Supplement plan allows you to be treated by any provider that accepts Medicare.

Predictability:

With the most popular Medicare Supplement Plans, you pay your monthly premium and your Part B deductible. Your plan covers 100% of your other out-of-pocket costs with Original Medicare. If you enroll in a Part D plan for your prescription drugs you pay the monthly premium, deductible and copays. That means you’ll have set costs each month.

With Medicare Advantage, you pay a flat copayment at the time of service. These copayments are usually between $5 and $75 for most outpatient services. Some months you may pay nothing at all if you choose a $0 premium plan and don’t need health care. You’ll never pay more than your plan’s out-of-pocket maximum also referred to as a safety net.

Will my Medicare Advantage Plan change each year?

Yes. The benefits, premiums, copayments, and additional benefits can change each year effective January 1.

Will my Medicare Supplement Policy increase in price each year?

Yes. Medicare supplement rate increases usually average somewhere between 3% and 10% per year. Pricing methods define how your Medicare Supplement monthly premiums will increase as you age, based on one of the following structures:

1. Attained-age pricing

2. Community-rated pricing

3. Issue-age pricing

Attained-age pricing bases the premium on your current age. If you have an attained-age pricing plan, your premium will increase each year.

Community-rated pricing doesn't let your age affect your premiums. Premiums can increase based on inflation and other factors such as tobacco use. If you have a community-rate pricing plan, you would be quoted the same rate as those both younger and older than you. 

Issue-age pricing bases the premium on how old you are when you buy the policy. The premium does not increase based on your age, but it can increase for other reasons.

If I choose a Medicare Advantage Plan, can I go back to Original Medicare Coverage and my Medicare Supplement?

Yes, there is a trial period for people who try Medicare Advantage for the first time. If you decide to dis-enroll from the plan and go back to Original Medicare within the first 12 months of Medicare Advantage coverage, then you can return to your Medicare Supplement policy with no underwriting. After the 12 months is up, then you are subject to underwriting.

Why does Karyn Goddard love her job?

I never dreamt that I would be selling insurance. However, I was offered a position with an agency that provided flexibility, freedom to travel and growth potential. Fast forward 17 years, and I’m still doing what I love!

I really enjoy helping people and working in this field gives me the opportunity to do that in many ways. Helping clients research plan options and finding those that are affordable for clients' lifestyles. I will help identify each person's needs, explain the products we offer and clarify each item. This helps clients know what plans cover and what it doesn’t. Answering questions, listening to concerns, and providing great protection is very satisfying to our entire team.

Insurance is never boring and a never-ending learning experience.  The industry constantly offers new products and regulations are always changing. It’s important for a good agent to stay current, offer clients relevant information and be available when you call.

Lastly, I get to talk to new people every day, learn about your lives, jobs, family and community. Who thought insurance could be so much fun!