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Florida Medicare Supplement Plans Versus Advantage Plans, How to Choose What’s Right For You


If you are 65 or over you have a difficult decision to make. Medicare Advantage plan or a Medicare Supplement plan.

Medicare is basically a 80/20 coinsurance health insurance. Most overlooked, are you aware of the penalties for NOT getting a Medicare plan? 10% per year penalty for NOT enrolling in a qualified plan. Prescription D has a 1% per month penalty for every month you did NOT enroll in a prescription plan.

Basically Supplement Plans can help pay for the 20% that Medicare does not pay. Medicare is primary in Supplement Plans.
Advantage plans are whole encompassing plans that make Medicare A & B secondary and their Advantage Plans primary.
Advantage plans are very similar to Employer Group insurance. They have a defined network of Doctors and Hospitals. They are usually offered as a HMO or PPO format.
They have “out of pocket” maximums, copays, per day charges for Hospital etc…
Advantage plans can also have a prescription plan included or not.

Supplement Plans generally do not have a defined network of, Doctors and Hospitals. The rule of thumb is, if they take Medicare they probably will take the supplement plans also. Why? Doctors and Hospitals surely would like to receive payment for their services instead of just 80%. Supplement plans generally do not have a prescription plan.

Ask yourself the questions when comparing.
1.Do my Doctors and Hospitals take the plan I am considering?
2.Is the plan a national plan or a regional plan?
3.Can I travel around the country and not have to pay extra for regular medical care? Most will say emergencies are always covered anywhere, but remember the phrase “regular care”. IE. I think I have the Flu, can I go to a regular Doctor when I am out of town or do I have to go to the emergency room?
4.What is my annual cost of care? When comparing this consider Insurance premiums and your personal medical needs. This should include; Doctor visits, known surgeries, prescriptions, testing, x-rays, mri’s etc. Add it all up annually not monthly.

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