Medicare Advantage and Medigap are examples of different types of health insurance cover, both offered by private insurance companies. Medicare Advantage plans replace traditional Medicare, whereas Medigap supplements it.
You have to choose one or the other and if you find you have made the wrong choice for some reason, you may want to make a change. You need to do this in the right way and at the right time if you want to ensure your eligibility and save costs.
Difference between Medicare Advantage and Medigap cover
Medicare Advantage plans must cover what Medicare Part A and B covers (except for hospice care) but often include extra benefits, such as dental, vision and hearing cover. Most of them also include cover for prescription drugs. Medigap cover pays for gaps in cover when you’re enrolled in Medicare Part A and B, including deductibles, co-payments and co-insurance.
The premiums for Medicare Advantage plans are generally lower than those for Medigap cover. Medigap cover works with any medical professional who accepts Medicare, whereas Medical Advantage plans are usually network-based and you need to consult specific medical professionals within the network.
The premiums for Medigap may be higher but your out-of-pocket expenses are usually lower and if you have high medical expenses, this is generally a good choice for you.
Sign up for Medigap cover in the open enrollment period
Russell Noga of Medisupps and an expert when it comes to Medigap cover says an insurance company can’t deny you Medigap coverage based on your age or any pre-existing medical conditions if you sign up in the open enrollment period. This period starts from the first day of the month in which you turn 65 and lasts for six months. You need to be enrolled in Medicare Part B to qualify.
Mutual of Omaha is a privately held company that started in 1909 and has grown to include a number of subsidiaries. One of their key plan types for the coming year is a Mutual of Omaha Medicare Supplement.
After the open enrollment period, the insurance company will take all health conditions into consideration and may deny you a policy or decide to charge you more.
Switch three months after enrolling in Medicare Advantage
You may sign up for Medicare Advantage but find that you could have more inclusive benefits or spend less money on an original Medicare plan with Medigap cover. If you enroll in Medicare Advantage when you first become eligible for Medicare, you may find that the policy you have chosen does not work as well for your healthcare needs as you expected.
You can switch within the first three months to traditional Medicare and Medigap. An insurance company can’t deny you coverage in this time.
Switch from Medicare Advantage back to Medicare Part A and Part B
You have the option to change from a Medicare Advantage plan back to Medicare Part A and B during the Annual Election Period from October 15 – December 7.
If you dropped a Medigap policy to join a Medicare Advantage plan and it’s the first one you’ve ever enrolled in, you can drop out of it at any time in the first twelve months after you’ve enrolled.
Otherwise, you can only switch back to Medicare Part A and Part B under certain conditions, such as if your Medicare Advantage plan leaves your area or you move to another area, your plan doesn’t service. You may also be able to switch if you to a nursing facility from home or back home from one.