Have you ever wondered whether having both a Medicare Advantage Plan and a Medigap policy would increase your coverage?
Naturally, you want the best Medicare coverage at the lowest price. So, coupling a low cost Medicare Advantage Plan with a Medigap policy (Medicare supplement) must be a good strategy… right?
Wrong! You cannot have both a Medicare Advantage Plan and a Medicare supplement at the same time and gain any benefit. And thinking that you can, only exposes the fact that you need to learn the differences between both types of Medicare plans.
Watch this short video to learn why having both types of Medicare plans is not a good idea.
Here’s why having both a Medicare Advantage Plan and a Medigap policy at the same time won’t work
The main reason you cannot have both types of plans and receive any benefit is due to how the plans work. They’re just not compatible.
A Medicare Advantage Plan is a Medicare health plan that is offered by a private insurance company and is sometimes referred to as Part C or merely, an Advantage plan. Insurance companies that offer Advantage Plans are contracted with the Centers for Medicare and Medicaid Services (CMS) to provide and administer your Medicare benefits.
Insurance companies are paid a fixed amount every month by CMS and plans must include all Part A and Part B benefits as well as follow other rules set by CMS.
Plans are often HMOs or PPOs and have their own cost-sharing amounts that you are required to pay. These are often deductibles, copayments and coinsurance. These cost-sharing amounts replace the Medicare Part A and B deductibles, charges for extended hospital stays and the 20% coinsurance for outpatient services.
For example, with a Medicare Advantage Plan, you may have a $50 copay for an emergency room visit rather than 20% of the entire charge required when you have original Medicare.
Advantage Plans often include Part D and some extra benefits like dental, vision, hearing and the Silver Sneakers Gym membership, not otherwise included in original Medicare. You are getting all of your Medicare benefits through one plan in many cases.
Medicare supplement policies are also available from private insurance companies. Medicare supplements are also called Medigap policies. These standardized plans pay a portion of your expenses for Medicare-covered services.
Some plans are more comprehensive than others. For instance Medicare Supplement Plan F will offer the most benefits compared to other plans. The more comprehensive a plan’s benefits the higher thew premium.
Because a Medicare supplement will pay a share of your costs, such as the Part A and Part B deductible and 20% coinsurance, it will not work with a Medicare Advantage Plan. Remember, an Advantage Plan replaces those standardized out-of-pocket costs with their own cost-sharing structure.
Both Medicare Advantage Plans and Medigap policies require that you continue to pay your Medicare Part B premium.
If you have a Medicare Advantage Plan, you will generally only be allowed to drop that plan and buy a supplement at specific times, known as enrollment periods and a once a year dis-enrollment period. You may be entitled to a special enrollment period based on your individual circumstances.
If you buy a Medicare supplement during the Annual Election Period, you should notify your Advantage Plan so your plan will not automatically renew for the following year.
If you have a supplement and have an enrollment period available and you join an Advantage Plan, you should notify your Medicare supplement provider when your Medicare Advantage Plan becomes effective. Otherwise, you will be paying for a supplement that is giving you no additional benefits, as your benefits will be provided by the Medicare Advantage Plan.