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About Tricia
Expertise
Has your medical insurance company denied your claim and refuses to pay? Have
you received a pre-authorization and still your insurance company
refuses to pay? How can you get your insurance company to reverse a
denied claim? How do you get a provider to waive your copayment if you
are financially unable to pay? Can a provider sue you for a unpaid bill and
will they? Can a provider send me to a collection agency for a medical bill?
If my insurance company does not pay, am I responsible? If you have these questions or others on why your insurance company is not paying your bills, I can help. I can give you "tricks of the trade" to get your insurance company to pay.
I have limited knowledge on Medicare and Medicaid and that is not my expertise. Each state is very different regarding Medicare and Medicaid so you need to review their website when you have questions. So please no Medicare or Medicaid questions!!
Experience
In the medical field for over 20 years spending majority of time in the collections aspect.
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You are here: Experts > Health/Fitness > Health Care: UK > Medicare, Medicaid, Insurance, HMO problems > Difference between medicare advantage and medigap plans
Expert: Tricia - 10/23/2009
Question
What are the differences between medicare advantage and medigap plans?
Answer
Hi Jack! I found this article on the Internet that will clearly explain the difference.
Medicare Advantage and Medicare Supplement Plans provide additional benefits to your Original Medicare coverage. The benefits offered by each type of plan are similar, so if you are in a Medicare Advantage Plan, you likely do not need a Medicare Supplement (Medigap) policy. Both types of plans require you to be eligible for Medicare Part A and continue to pay your Medicare Bart B premium each month in order to participate.
Medicare Advantage Plans are offered by private insurance carriers (such as Kaiser or PacifiCare) and can be Health Maintenance Organizations (HMOs), Preferred Provider Organization (PPO) plans, or Private Fee-for-Service and Specialty Plans. Generally, these plans provide all of the coverage of Original Medicare as well as extra benefits and services such as chiropractic, prescription drugs and hearing aids. Additionally, gym memberships, preventive care services, dental, vision and access to disease management programs may also be
covered. You can purchase a Medicare Advantage Plan in addition to Original Medicare coverage (Parts A and B). Your monthly premium for a Medicare Advantage Plan will depend on the benefits offered and type of plan in which you enroll.
Medicare Supplement Plans (Medigap)
Also know as a Medigap plan, a Medicare Supplement Plan is an insurance policy sold by private companies to help you pay health care costs that Medicare does not cover such as coinsurance, copayments and deductibles. Medicare Supplement Plans work in conjunction with Medicare Parts A and B to lower your out-of-pocket costs and provide more health insurance coverage.
Take a moment to evaluate your health needs before you decide on enrolling in either a Medicare Advantage or Medicare Supplement Plan. If you are in relatively good health and see a doctor only for routine care, an Advantage plan with a lower monthly premium and cost sharing may be a better choice. If you are in poor health or are regularly hospitalized, you can benefit greatly from a Medicare Supplement plan that offers 100% covered care at a higher monthly premium.
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