The short answer is yes. It is a good idea to have a secondary insurance in place in order to supplement what Medicare Parts A and B do not cover. Whether it is an Advantage plan or traditional supplement, you will almost always benefits from secondary coverage.
In our opinion, supplement plans are the more comprehensive insurance plans. Consumers might pay higher monthly premiums, but their out of pocket expenses will be much less with a Medigap policy. And there are few if any network restrictions. Like all things in life, you get what you pay for.
It should be noted that some will remain on their employer group coverage (groups over 20 members) and enroll in Medicare Part B at a later date. Enrolling in Medicare Part B will be the time to purchase supplemental coverage.
Medicare Advantage plans can be tricky. When you enroll in this coverage, you are allowing a private insurance company to cover what Medicare normally would through Parts A & B. Advantage plans insure you for what Original Medicare usually covers and part of what it does not – and they typically include Part D drug coverage. By law, you cannot be enrolled in both a supplement and an Advantage plan at the same time however.
If you are healthy, like any other insurance, you need not worry about your plan. In fact, you will probably save money by enrolling in an Advantage Plan as the premiums are usually lower than Medicare supplements life Plans F, G, or N.
However, if you get sick and have any major claims, Advantage plans will typically have much larger out of pocket expenses for the insured. In the long run, you may not have saved any money at all. In fact, you could be spending a great deal more.
The other issue with Advantage plans is that they are network driven plans. If you choose Humana or United Healthcare, then you will want to make sure your doctor(s) accept that coverage. Going out of network for care can expose you to even more out-of-pocket expenses.
It should be noted that in some states, like Ohio for instance, those under age 65 who are eligible for Medicare due to disability cannot purchase a traditional Medicare supplement. In these cases, a Medicare Advantage plan will be the only other option to Original Medicare.
There are no restrictions at age 65 for preexisting conditions when purchasing a supplemental plan. However, there can be after your six month open enrollment window has closed… depending on your situation.
Like many health insurance products, you need to be healthy in order to purchase and be accepted into a plan if you are not in open enrollment. If you have enrolled in an Advantage plan and the insurance company leaves your area – and your health has deteriorated – you will have fewer opportunities to purchase a supplemental policy.
Of course, there is a place for Advantage plans. Seniors who have missed their opportunity to enroll in a Medicare supplement and cannot otherwise qualify for one or who are operating on a tight budget might consider Advantage coverage. But if you are in good health and have the means, a Medicare Supplement might be your first choice.
Hyers and Associates is an independent agency specializing in Medicare supplement insurance coverage across the U.S. Contact us today to discuss your options in more detail.