Medicare Supplement or Advantage Plan? Choose carefully.

It’s time to enroll for Medicare additional insurance for 2015.  The open enrollment period runs until December 7.  If you are on Medicare, make sure to get your enrollment done by then.

It isn’t necessary to have Medicare additional insurance.  People on Medicare can choose to cover the 20% Medicare co-pay by themselves.

If, though, you prefer to buy insurance for the co-pay, choose your insurance carefully.  The types of plans available fall into two broad categories: (1)  Advantage Plans and (2) supplements.

Advantage Plans generally are less expensive.  Supplements are generally more expensive.

Advantage Plans are built like Health Maintenance Organization (HMOs.)  They have a more restrictive provider list but usually provide more preventive medicine support.  Supplements are traditional fee for service plans, so preventive services mostly take place only when initiated by the insured person.

After a major illness or injury that requires rehabilitation therapy (“rehab,”) supplements usually are more generous than Advantage Plans.  Medicare itself allows 100 days of rehab, 20 paid fully by Medicare and the rest subject to the 20% co-pay.

Advantage Plans pay close attention to the insured person’s progress during therapy and, if they don’t see adequate progress, will cut off payments for rehab days very quickly. Some insured people have their rehab coverage end just a few days past the 20 days that are fully covered by Medicare.

Supplements, with a few exceptions, do not cut off rehab days.  Most insureds with supplements get most or all of the 100 available rehab days.

So, my suggestions for choosing between Advantage Plans and supplements are:

No matter your preference, seek out a Medicare insurance agent that represents more than one insurer.  Don’t just assume that the person at the table in your local grocery, pharmacy, or department store can give you all the options.  If the person at that table sells insurance for just one company, find someone else.

But, don’t go it alone.  Get help from an insurance broker.  These insurance plans are complicated, and there are many different choices among Advantage Plans and among supplements.  Let someone help you figure out your best options.  Their help doesn’t cost you anything.  They’re paid by the insurer you choose.

Choose your plan wisely.

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