Do You Need Medicare Part B with an Advantage Plan?

Do You Need Medicare Part B with an Advantage Plan?

December 08, 20244 min read

Understanding Medicare Advantage and Original Medicare

Medicare Advantage, also known as Part C, is an alternative to Original Medicare, which includes Part A and Part B. These plans are offered by private insurance companies approved by Medicare. They provide all your Part A and Part B coverage and may offer extra benefits that Original Medicare doesn't cover, such as vision or dental care.

Original Medicare covers hospital stays, skilled nursing facility care, and some home health care under Part A. Part B covers doctor visits, outpatient care, and some preventive services. If you're considering enrolling in a Medicare Advantage Plan, it's crucial to understand how these plans work with Original Medicare.

Coverage: What You Need to Know

Medicare Advantage Plans must provide the same benefits as Original Medicare, but with added features. These plans usually include drug coverage, also known as Part D. When you join a Medicare Advantage Plan, you’ll still need to pay your Part B premium, along with any additional premium the plan may charge.

  • Part A: Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

  • Part B: Covers certain doctors' services, outpatient care, medical supplies, and preventive services.

  • Part D: Prescription drug coverage.

Medigap and Medicare Advantage: Compare Benefits Side-by-Side

Medigap, or Medicare Supplement Insurance, helps cover some of the healthcare costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles. However, Medigap policies can't be used with Medicare Advantage Plans. If you join a Medicare Advantage Plan, you cannot buy Medigap.

It’s important to compare the benefits side-by-side to decide what works best for you. While Medicare Advantage Plans offer extra benefits and include drug coverage, they might have network restrictions. On the other hand, Medigap offers more flexibility with providers but requires separate Medicare drug coverage.

Drug Plan Options

When you enroll in a Medicare Advantage Plan, drug coverage is often included. However, if it is not, you have the option to join a separate Medicare drug plan. Choosing the right drug plan depends on the medications you take, the costs, and the pharmacies included in the plan's network.

It's essential to review your current prescriptions and ensure that any plan you consider provides the necessary coverage so you can manage your medication costs effectively.

Join a Medicare Advantage Plan: Eligibility and Enrollment

To join a Medicare Advantage Plan, you must have both Part A and Part B and live in the plan’s service area. You can enroll during the Initial Enrollment Period when you first become eligible for Medicare or during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31 each year.

If you want to switch or drop your Medicare Advantage Plan and return to Original Medicare, you can do so during the Open Enrollment Period. Keep in mind that if you return to Original Medicare, you may want to buy a Medicare Supplement Insurance to help pay your share of costs.

Part C and Part B: What Do They Cover?

Part C, or Medicare Advantage Plans, cover everything that Part A and Part B cover. They often include additional health coverage, like vision, hearing, and dental. Part B services cover outpatient care, doctor visits, and preventive services. Even if you choose a Medicare Advantage Plan, you will still pay a monthly Part B premium.

Understanding the different parts of Medicare can help you decide whether to stay with Original Medicare or enroll in a Medicare Advantage Plan. Each has its own set of benefits, and what works for one person may not work for another.

Buying Medigap: Is It Right for You?

If you're considering buying Medigap, it’s important to know that these policies can help cover costs not paid by Original Medicare. However, they don’t cover prescription drugs, so you would need a separate drug plan for that. Medigap policies are sold by private companies, and the costs can vary.

Medigap can be a great choice if you prefer the flexibility of seeing any provider that accepts Medicare, without the need for referrals. However, it might not be the best fit if you want the additional benefits offered by Medicare Advantage Plans.

We're Here to Help

Making the right choice between Original Medicare and a Medicare Advantage Plan can be challenging. Bourgeois Insurance Agency, LLC in Thibodaux, Louisiana is here to help. Our team can guide you through your options and ensure you have the coverage that meets your needs.

Call us today at (985) 803-8999 to speak with a knowledgeable representative about your Medicare options. Let us assist you in making the best decision for your health coverage.

Price Started in the insurance industry over 20 years ago. Working for several well known large corporations over the years but found he could serve his clients and community better as an Independent Agency offering Medicare Supplements (Medigap), Medicare Advantage Plans, Prescription Drug Plans (PDP), and Retirement Planning Services.

Price has spent years building one of the top agencies in the Thibodaux, Louisiana. Dedicated to finding the best solutions and staying up to date on insurance trends and products.

Price Bourgeois

Price Started in the insurance industry over 20 years ago. Working for several well known large corporations over the years but found he could serve his clients and community better as an Independent Agency offering Medicare Supplements (Medigap), Medicare Advantage Plans, Prescription Drug Plans (PDP), and Retirement Planning Services. Price has spent years building one of the top agencies in the Thibodaux, Louisiana. Dedicated to finding the best solutions and staying up to date on insurance trends and products.

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