If you live in Fort Lee, New Jersey, and you’re trying to decide between Medicare Advantage and Medicare Supplement Insurance (Medigap), you may feel like everyone has an opinion about what you should do.
One person tells you Medicare Advantage is the way to go because some plans have low or even $0 monthly premiums. Someone else tells you they would never give up their Medigap policy. Then there are television commercials, mailers, online advertisements, and advice from friends and relatives.
It can become overwhelming very quickly.
But here is something I want Fort Lee seniors to understand:
There is no single Medicare option that is right for everyone.
The better question isn’t:
“Which type of Medicare coverage is best?”
It’s:
“Which type of Medicare coverage fits the way I actually use healthcare?”
That distinction matters.
A person who regularly sees several specialists may have very different priorities from someone who rarely visits a doctor. Someone who spends several months each year outside New Jersey may look at coverage differently from someone who receives nearly all of their care close to home.
And someone taking several prescription medications may need to evaluate things that another person doesn’t.
That’s why I encourage people to slow the decision down.
Before choosing Medicare Advantage or Original Medicare with a Medigap policy, look at your doctors, hospitals, prescriptions, budget, travel habits, and how comfortable you are with potential out-of-pocket costs and plan rules.
In this guide, I’ll walk you through seven questions I believe Fort Lee Medicare beneficiaries should ask before choosing between Medicare Advantage and Medigap.
The goal isn’t to tell you which one you should choose.
It’s to help you understand what you should be looking at so you can make a more informed decision.
Medicare Advantage vs. Medigap: First Understand What You’re Actually Comparing
Before we get to the seven questions, we need to clear up one of the most common sources of Medicare confusion.
Medicare Advantage and Medigap are not two versions of the same thing.
They work differently.
How Medicare Advantage Works
Medicare Advantage, also called Medicare Part C, is an alternative way to receive your Medicare Part A and Part B benefits.
You enroll in a Medicare-approved plan offered by a private insurance company.
You still have Medicare, and you must continue to have Part A and Part B, but the Medicare Advantage plan administers your Medicare-covered healthcare.
Depending on the plan, you may have:
- A provider network
- Copayments or coinsurance when you receive care
- Prior authorization requirements for certain services
- An annual maximum out-of-pocket limit for covered Part A and Part B services
- Prescription drug coverage included in the plan
- Additional benefits that Original Medicare doesn’t normally cover
Many Medicare Advantage plans include Part D prescription drug coverage, and some offer additional dental, vision or hearing benefits. Benefits, costs, provider networks, formularies and plan rules can vary from one plan to another and can change from year to year. Medicare also notes that Medicare Advantage plans have annual limits on what members pay for covered Medicare services.
How Original Medicare + Medigap Works
With this approach, Original Medicare remains your primary Medicare coverage.
Original Medicare consists of:
- Medicare Part A — Hospital Insurance
- Medicare Part B — Medical Insurance
You then purchase a separate Medicare Supplement Insurance policy, commonly called Medigap, from a private insurance company.
The purpose of Medigap is to help pay certain out-of-pocket costs left behind by Original Medicare, such as some deductibles, copayments and coinsurance, depending on the Medigap plan you select.
If you want prescription drug coverage, you would generally also enroll in a separate Medicare Part D prescription drug plan, because Medigap policies sold after 2005 don’t include prescription drug coverage.
One important distinction is provider access.
With Original Medicare, you can generally use any doctor or hospital in the United States that accepts Medicare. Medicare Advantage plans may require you to use providers within the plan’s network for non-emergency care, depending on the type of plan.
That difference brings us to the first question I would ask.
Question 1: Are Your Doctors and Specialists in the Plan’s Network?
This is where I believe a Medicare comparison should begin.
Not with the premium.
Not with the dental allowance.
Not with the television commercial.
Start with your healthcare.
If you already have doctors you trust, write them down before comparing Medicare Advantage plans.
That might include your:
- Primary care physician
- Cardiologist
- Oncologist
- Orthopedist
- Endocrinologist
- Ophthalmologist
- Other specialists you see regularly
Then look at the hospitals and medical systems you prefer to use.
Why This Is Especially Important in Fort Lee
Living in Fort Lee gives residents access to healthcare on both sides of the Hudson and throughout Bergen County and the surrounding region.
That can make provider access particularly important.
You may have one physician close to home but see a specialist elsewhere. You might receive testing at one facility and treatment at another.
A Medicare Advantage plan can have an excellent premium and attractive benefits, but those benefits may matter much less if an important physician isn’t available to you under the plan’s network rules.
Medicare explains that people with Original Medicare can use any doctor or hospital that accepts Medicare anywhere in the United States. With Medicare Advantage, you may need to receive non-emergency care from providers within the plan’s network and service area; some plans allow out-of-network care but may charge more.
Different Medicare Advantage plan types can also work differently. For example, HMOs generally have more restrictive network rules, while PPOs may permit out-of-network services at a higher cost.
From My Office
One of the most important things I can tell someone comparing Medicare plans is this:
Don’t ask only, “Does my doctor take Medicare?”
That question isn’t always enough.
If you’re considering Medicare Advantage, ask whether your doctor participates in the specific plan and network you’re considering.
Those are two different questions.
And don’t stop with your primary doctor.
A specialist you see only three times a year may be far more important to your healthcare than a benefit you use once or twice.
This is one reason I like to start Medicare conversations with a person’s actual doctors and prescriptions instead of starting with a stack of plan brochures.
Your Medicare coverage should work around your healthcare needs—not the other way around.
This question requires looking beyond the number printed next to “monthly premium.”
A low premium can certainly be attractive.
But your monthly premium is only one piece of your total healthcare spending.
Medicare Advantage Costs Can Work Differently
Some Medicare Advantage plans have a $0 plan premium, although you generally must continue paying your Medicare Part B premium.
Depending on the plan and services you use, you may then pay copayments or coinsurance when you receive healthcare.
For example, a plan may have different costs for:
- Primary care visits
- Specialist visits
- Diagnostic testing
- Outpatient procedures
- Emergency room visits
- Hospital stays
- Durable medical equipment
The actual amounts depend on the individual plan.
The important point is that a lower monthly premium does not automatically mean lower total healthcare costs.
Medicare Advantage plans do, however, have an annual maximum on what you pay out of pocket for covered Medicare Part A and Part B services. Once you reach the applicable plan limit, the plan pays the covered Medicare costs addressed by that limit for the remainder of the year.
Medigap Takes a Different Approach
With Original Medicare plus Medigap, you pay a separate monthly premium for the Medigap policy.
Depending on which standardized Medigap plan you choose, the policy can help cover certain costs that Original Medicare leaves you responsible for.
This can make healthcare spending feel more predictable for some people.
But that predictability comes with a monthly premium.
And remember: a Medigap policy doesn’t replace Medicare. Medicare generally pays its share of an approved covered service first, and the Medigap policy then helps pay according to the benefits of that policy.
You may also have a separate Part D premium if you enroll in prescription drug coverage.
A Simple Way to Think About It
I often encourage people to think about the difference this way:
Would you rather pay more of your healthcare costs through predictable monthly premiums, or are you comfortable with potentially lower plan premiums and paying certain costs when you use healthcare?
Neither answer is automatically right or wrong.
It depends on your budget, healthcare usage and personal comfort level.
Someone who rarely uses medical services may view this differently from someone who regularly sees multiple specialists or receives ongoing treatment.
And that is exactly why comparing Medicare based solely on premium can lead people in the wrong direction.
Before We Continue: Don’t Choose Medicare Coverage Based on One Number
If you remember only one thing from this first part, I hope it’s this:
Medicare coverage is not a one-number decision.
The lowest premium isn’t automatically the lowest-cost option.
The plan with the most extra benefits isn’t automatically the best fit.
And the option your neighbor loves isn’t automatically the option you should choose.
A meaningful comparison considers the entire picture:
Your doctors. Your prescriptions. Your expected healthcare use. Your travel. Your budget. Your comfort with networks and plan rules. And what could happen if your healthcare needs change.
